Refer a Service User
Thank you for considering referring your service user to Body Positive. Please complete the following form to start the referral. If you identify your service user as a risk you will be taken to an additional page to ensure we can safeguard your service user and the staff of Body Positive. All information is kept in accordance with the Data Protection Act. For details of our confidentiality and data management policies please contact us using the main e-mail address, health@bpcnw.co.uk.
Your Name
Your answer
Your Agency
Your answer
Contact Detail
This should be your telephone number, mobile number or e-mail address.
Your answer
Reason for Referral
Your answer
Risk Assessment
Is there is any history or present risk of violence, aggression towards others, self harm, fire damage/ arson, sexual harassment/exploitation, risk to safeguarding of children / vulnerable adults, or is there any additional information you feel that we need to know in order to work with this person?
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