The Small Project Referral Form
SUMMER CLOSURE: We will be closed throughout August except to very urgent referrals. Please contact
jane@thesmallproject.org.uk
and cc
linda@thesmallproject.org.uk
during August if you have any questions.
CORONAVIRUS: Pre-made bundles of clothes and equipment can be collected by families/referrers on Saturdays by arrangement. We also offer a delivery service.
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Hi. If you're a social sector/health professional and you'd like to make a referral to The Small Project please fill in the form below. You can contact us with any queries at
jane@thesmallproject.org.uk
or 07456 680037. We'll normally get back to you within a few days to update you on the progress of your referral.
The Small Project is based at Oasis Playspace - a wooden hut in Geraldine Mary Harmsworth Park (right next door to the Imperial War Museum), SE1.
* Required
Agency Name and Department/Team
*
eg., St Thomas' Hospital, Neonatal Intensive Care Unit
Your answer
Address
*
Your answer
Name of Advisor
*
Your answer
Telephone Number
*
Your answer
Email Address
*
Your answer
Client Details (Parent/Carer)
Name
*
Your answer
Postcode
Your answer
Telephone Number
*
To arrange clothes collection date and time with the client
Your answer
Email address
To send families news and updates about the service and reminders to return for more clothing
Your answer
Number of children (aged 0-5yrs) requiring clothes
*
Your answer
Referral Details
Reason for Referral
*
Please give a brief explanation of why the family are in need of children's clothes/other items
Your answer
Clothes Size and Gender Needed
*
We will prepare a bundle of clothes to collect eg. 6-9mth girl or 2-3r boy (our clothes sizes are: newborn/0-3mth, 3-6mth, 6-9mth, 12-18mth, 18-24mth, 2-3yrs, 3-4yrs, 4-5yrs)
Your answer
Any Specific Clothing/Equipment Needs
Please state if the family need nappies (including size) or any other items such as baby carriers, toys, sleeping bags, bibs etc, and we will provide if we are able to.
Your answer
Any Other Relevant Information About the Family
e.g., information which may aid the referral and clothes collection process
Your answer
Clothes Collection
Collection
*
Collection is normally from Oasis Playspace in the grounds of the Imperial War Museum. During August (for urgent referrals) this will be by arrangement. Please let us know if the family or the referrer will collect.
Your answer
Feedback
Any feedback, comments and questions are welcome .... Thank you!
Comments
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