Make a referral

If you wish to refer yourself, please complete the Self-referral form.


Reasons for referral

Please provide as much detail here as possible as this will aid us in considering your referral as quickly as possible.

Personal details

E.g., 18/12/2018
E.g., 18/12/2018

The person's experiences

The Helen Bamber Foundation (HBF) works with survivors of human cruelty i.e. extreme physical, sexual and / or psychological violence. The specialist services HBF offer are most suitable for survivors of multiple and repeated acts of cruelty, who are also seeking legal protection in the UK (i.e. asylum seekers).

Please indicate below the context and the cruelty suffered by the person being referred, please note each option has sub-categories for further clarification and detail. Please tick all relevant boxes, including reviewing all relevant sub-categories and try to be as specific as possible, as this will allow us to assess if HBF is the appropriate organisation to offer support.


Housing information

Safe house help text

Detention

E.g., 18/12/2018
Files must be less than 100 MB.
Allowed file types: pdf.
E.g., 18/12/2018
Files must be less than 100 MB.
Allowed file types: pdf.
Files must be less than 100 MB.
Allowed file types: pdf.
E.g., 18/12/2018

Health

Please refer to the HBF webpage ‘How to access healthcare'


Referrer contact details

Your contact details


Additional contacts

Additional contacts (click to expand):

NGO case worker / key worker


Documentation

Please tick which of the following documents are available. You can then upload them to our secure database, using the upload button below.

Upload documents
Files must be less than 50 MB.
Allowed file types: pdf doc docx.

To finish and submit the referral, please press below.
The next page will show you a preview of your referral for you to review before you submit it.