The Small Project Referral Form
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.

Referring Agency
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 0-3yrs) 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
Details of All Children Requiring Clothes *
Including date of birth, gender, current clothing size if known
Your answer
Any Specific Clothing/Equipment Needs
(Subject to Availability)
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
Who Will Collect The Items? *
Who will collect - you (the referrer) or the family? Some families who are referred don't manage to visit us so you may want to collect on their behalf. Please suggest a date (Thursdays) and we will be in touch to confirm. Collection is normally from Oasis Playspace in the grounds of the Imperial War Museum on Thursday mornings 10 am -12 noon. If the family are collecting we will contact them to make arrangements.
Your answer
Feedback
Any feedback, comments and questions are welcome .... Thank you!
Comments
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