Freeva Helpline: 0808 802 0028 | 24-Hour National Domestic Abuse Helpline: 0808 2000 247
Please ensure the form is completed in full including support needs and background information. We will also need information about the alleged perpetrator to ensure robust safety planning. You can complete our online referral form or download a copy and email it to us using the contact details below.
Support for Clients at Current Risk of Significant Harm
Please download and complete the MARAC Referral Form and submit completed form to the MARAC Coordinator at the following address: [email protected].
Please note:
If you are submitting a MARAC referral without the consent of the victim/survivor, please ensure that you also complete and submit the Sharing Without Consent Form.
Standard, Medium Risk or Unknown Risk
This referral form is for any agency that would like to refer an individual for domestic abuse support.
Please note:
Consent is required for these referrals. If you do not have the consent of the victim/survivor but are concerned that the victim/survivor is at significant risk of harm, please complete and submit the MARAC Referral form alongside the Sharing Information Without Consent forms to the MARAC Coordinator at [email protected].
This referral form is for Police Colleagues referring for domestic abuse support.
Please note:
A copy of the PPN will need to be uploaded to the referral.
Sexual Abuse Support (any agency inc., Police colleagues)
This referral form is for any agency including Police colleagues that would like to refer an individual for support in relation to the sexual abuse they have experienced.
Jenkins Project (any agency inc., Police colleagues)
This referral form is for any agency that would like to refer an individual using harmful behaviours to our Behaviour Change Programme.
Please review our Eligibility Criteria before submitting a referral, here.
Send a completed copy of the referral form to:
Non-Secure: [email protected]
Secure*: [email protected]
If you are looking up information on behalf of someone else, read our article on how to support others.
Whether you are looking for information for yourself or others, browse our resource library for posters, booklets and information leaflets.