The Small Project Referral Form
CORONAVIRUS: Pre-made bundles of clothes and equipment can be collected by families/referrers on Thursdays by arrangement.
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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 Sam with any queries at:
thesmallproject@oasiswaterloo.org
or 07456 680037. We'll normally get back to you within a week to update you on the progress of your referral.
By filling in this form, users are consenting for data to be held by Oasis Hub Waterloo for necessary operation of the service.
We are located at the Oasis Play Space SE11 4TU. Unfortunately the Small Project is unable to deliver bundles. Please take into account the distance the service users will need to travel in order to pick up bundles.
Finally, note that at The Small Project we can speak Spanish. If you are referring a service user who does not speak English or Spanish and are unable to pick up the bundles on behalf of the Service user we will try our best to communicate with them, please let us know the level of English and which language they speak if appropriate in the "any other relevant information about the family box".
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* Required
Name of Organization
*
eg., St Thomas' Hospital, Neonatal Intensive Care Unit, Coin Street nursery
Your answer
Address of organization
*
Your answer
Name of Advisor
*
Your answer
Telephone Number
*
Your answer
Email Address
*
Your answer
Client Details (Parent/Carer)
Name
*
Your answer
Postcode and Borough
*
Your answer
Date of birth of service user (mum, dad, or carer)
Your answer
Telephone Number (please fill out without spaces in following format 447496462414)
*
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 0-9yrs) 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, 5-6yrs, 6-7yrs, 7-8 yrs, 8-9yrs)
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 on Thursday mornings. 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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