Domestic/Sexual Violence Referral Form

Are you looking to refer a service user to Support U from your agency?

We provide a wide range of specialist support services for members of the LGBT+ communities and their allies. As such, from time to time it may be best to refer your clients to us for assistance by our specialist LGBT+ domestic and sexual violence service. Our team of dedicated staff are here to help connect your service user to the relevant support they need both within the charity and through statutory providers such as the police/local authorities.

PLEASE NOTE: Support U is not a crisis centre, and therefore, we are unable to see clients with serious or complex mental health issues. After completion of this form, the Frontline team will review each referral to ensure that we are able to support the individual and their specific set of needs. If we are unable to provide support, we will look for any suggestions or referral pathways for the client.  

We ask that all referrals are submitted using the below form, and that you complete as much detail as possible. There are some fields that are mandatory for submission as we require this information in order to successfully assess and assist our clients.

    Your Details


    Client Details


    Current Housing Situation


    Referral Details


    Sexual Violence/Abuse

    Please complete this section if this referral relates to a Sexual Violence or Sexual Abuse concern


    Perpetrator Information


    Reporting/Police


    Disclaimers




    Support U provides this referral service, and its services to the end user in line with its terms and conditions of service. By submitting this form you are agreeing to the terms and conditions outlined, and confirm on behalf of your referral individual that they are aware of and acknowledge these terms and conditions.