ASSIST Sheffield Referral Form

Referral form for agencies to complete when referring individuals to ASSIST Sheffield.

Please be aware that we can only accept referrals for single adults who have applied for, and subsequently been refused, asylum in the UK. If the person you are seeking to refer does not meet this criteria please contact City of Sanctuary Sheffield (07419348379) or the British Red Cross (0114 2427385).

Please also be aware that we cannot provide legal advice to individuals as immigration advice is regulated by the Office of the Immigration Services Commissioner (OISC). However, we may be able to signpost individuals to other legal advice organisations.

If you have any questions or require any help with the form please contact the ASSIST Office on admin@assistsheffield.org.uk or 0300 201 0072.


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Email *
Untitled title
Your details
Please complete the following fields with information regarding who is making the referral to ASSIST
Full name of person completing the form *
Your name
Name of referring organisation *
The name of the organisation which is making the referral to ASSIST
Your contact phone number *
Please provide a contact phone number for you
Details of the individual requiring ASSIST support
Please provide the following information so that we can determine the eligibility and suitability of the person you are referring to ASSIST
First name(s) *
Surname *
Gender *
Date of birth *
MM
/
DD
/
YYYY
Country of Origin *
Contact phone number *
Address
Languages spoken
Does the client require an interpreter? *
Immigration Status *
Support provided and assessment of support required
The following questions are to determine what support you have provided to the individual already, and what support you believe they may require from ASSIST
What support have you already provided to this person? *
eg. Money, accommodation, food etc. Please provide as much information as possible, including the timeframes for your support
What support do they need from ASSIST? *
What is the reason for your referral to ASSIST? What support do they require? eg. money, accommodation, when their current accom is ending, etc
Where are they currently living? *
Are there any other agencies involved in their care?
Please provide details, including contact details wherever possible, of any other agencies currently involved in providing care or support to this individual.
Are there any risk factors around this individual of which ASSIST should be aware?
Please provide any information regarding safeguarding concerns or support needs, such as: disabled access, history of mental illness, self harm or suicidal intentions, substance misuse, convictions of any kind, anti-social behaviour (e.g. known violence/aggressive behaviour)
Do you consider this individual to have high support needs? *
Is there proof of status or eviction date?
If the individual has received documentation from the Home Office which shows their immigration status, asylum decision and/or the date they are due to be evicted, please email these to clientsupport@assistsheffield.org.uk
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