The support we provide is tailored to the individual needs of those we help and we focus on offering practical and emotional support to help those going through difficult times. This form is for referring someone else for our help.
Please see a link to our Privacy Information Statement below which confirms how we store and record the information that you are sharing with us: https://ourspecialfriends.org/wp-content/uploads/2018/12/Privacy-Statement-OSF-Website-Version.pdf
If you have an emergency, please contact: • 999 - Emergency Services • 111 (option 2) for mental health help in a crisis • your Vet/nearest Veterinary Surgery for animal emergencies
Their details:
Title:
Full Name:
Date of Birth:
Email:
Full Address and postcode:
Tel No (s):
Date of referral:
Reason for Referral/Current situation:
Reason for Referral / Current situation:
Experience of and interest in animals:
Preference of species (dog/cat/other):
Level of their Mobility:
poor
Medium
Good
Other organisations involved:
What service(s) do they require?
Advice, guidance, or support with their pet's health and/or welfare
Foster care for their pet
Advice, guidance, or support related to their own health
Support to adopt a new pet
Emotional support, including bereavement support
Dog walking (volunteer taking their dog for a walk)
Transport for their pet to receive veterinary or other care
Visits from a volunteer and their pet (Animal-Assisted Activity) either at home or going for a walk together
Financial support towards veterinary or other animal care costs
Other:
Please enter your details below:
Organisation Name:
Organisation Address:
Relationship to the person you are referring:
Is the client aware referral is being made:
YesNO
