LinkAges Connect Referral Form
Thank you for your interest in referring someone to LinkAges Connect.

You can refer people over 65 in Oxford City to our LinkAges Connect programme. The programmes aims to introduce younger and older people in Oxford City to spend time together one-on-one and get out and about in the community. We match up people based on proximity, and try our hardest to bring people together based on mutual interests to create genuine, long lasting friendships. Pairs could go for afternoon tea, go to the theatre or attend a local activity such as a lunch club or IT class.

This programme is designed to support pairs to get out and about, and be active in the local community. It is not, therefore, a traditional 'home visit' befriending service, and may not be suitable for house bound people. Please bear this in mind when considering the suitability of the person you intend to refer to the programme.

Please fill out the form below and one of the team will be in touch to discuss their eligibility for the programme.

Email address *
I am: *
What organisation do you work for? (if applicable)
Your answer
First Name *
Your answer
Last Name *
Your answer
Telephone number *
Your answer
Email address *
Your answer
Please confirm that you have received the consent of the older person to make this referral (we cannot guarantee a place on the scheme but we need you to have asked for permission to share their details) *
Required
Please confirm that you believe that the older person is suitable to participate in this programme. *
Reminder: this programme is designed to support pairs to get out and about, and be active in the local community. It is not, therefore, a traditional home visit style befriending service and may not be suitable for housebound people. Please bear this in mind when considering the suitability of the person you intend to refer to the programme.
Older Person's details
First Name *
Your answer
Last Name *
Your answer
Date of birth (dd/mm/yyyy) *
Your answer
Address *
Please note that we are only taking referrals for Oxford City
Your answer
Telephone number *
Your answer
Reason for referral *
We're looking for approximately 100-200 words to give context to your referral.
Your answer
Medical information: *
Please note that we are not able to take referrals for people living with severe unmanaged mental health conditions.
Your answer
Living arrangements *
Your answer
Any other information *
Your answer
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