Hidden Help Referral Form

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Referrer: please complete this form in full. Completion of the form is an application for referral and does not guarantee we are able to help. A referral is only in place once you have received confirmation and a referral number. N.B. incomplete information may slow down client support.

(Any questions please contact Wendy: admin@hiddenhelp.org Tel: 07375994532)

Referral organisation *

Upon completing this form we will assign/ send you a referral number and a item Wishlist form for your client to fill out so they can select exactly what they need.

Referrer’s name *

Referrer’s contact number *

Referrer’s email *

Client's first name *

Client contact number *

First part of client's postcode *

Is the client "vulnerable"? *

Yes

Can the items be collected or is delivery by Hidden Help required? *

*Deliveries are not always available. If a delivery is requested, please confirm whether to send a card payment link for the delivery fee by selecting the correct box below

We can collect

Delivery is required (£10/£20): please send card payment link

Delivery is required (£10/£20): please send an invoice

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