Referral

Referral2025-06-19T16:44:47+01:00

Entraide provides advice, advocacy and practical support to asylum seekers, refugees and migrants. The support is tailored to the needs of the client and can include: support to access legal advice, support to access education, health, welfare benefits, housing, training and employment, etc.

We also provide advice on the same issues, referrals and practical support during destitution.

To refer a client, please complete the form below or download the form and email it to us.

Any questions please call us on 0121 788 1087

Date of Referral

Name of referrer or own name if self–referral

Referrers Address

Referrer’s Telephone Number

Referrer’s Email

Client's Name

Client's Address

Client's Telephone Number

Date of Birth of Client

Gender of Client

Male

Female

Unknown/Undisclosed

Country of Origin

Can they communicate in simple English?

Yes

Does the client have any children?

Yes

Please provide the children’s names and ages below

Other Needs and Vulnerabilities

What help would the client like?

Immigration advice

Help with housing

Help with accessing support (e.g. benefits or Local Authority support)

Emotional support

Help with accessing services such as health and education

Other (please specify)

What other help would the client like?

What actions have been taken with regards to the client’s needs and what was their outcome?

Does the client consent to this referral to Entraide?

Yes

Please note the sections on this referral form are optional, if the client does not wish to share their information in advance of coming to the service this is fine and any information on this referral form is confidential and will not be shared with other parties under the Data Protection Act without the consent of the client.

Thank you for your referral. It has been sent and we will be in touch soon.

There was an error trying to send your referral. Please try again later.