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Hampshire Macmillan Citizens Advice Service Direct Referral Form
Please use this form to make a direct referral to one of our caseworkers in the Hampshire Macmillan Citizens Advice Service.
A receipt will be sent to you on submission of this form.

Our service is for people affected by cancer who are resident in or being treated in Hampshire, including Southampton, Portsmouth and the Isle of Wight. This includes patients, families and carers.
We aim to respond to referrals within three working days.

If you need help with the form or want to speak to one of our caseworkers, please call 0344 847 7727

Our privacy policy can be found here:
https://www.citizensadvice.org.uk/about-us/citizens-advice-privacy-policy/when-you-get-advice-from-an-adviser/
Your name, outreach location, contact email/telephone details *
The client is aware of and has agreed to this referral and has agreed to the storing and processing of personal and special category data *
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