Our Special Friends

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

Title:

Full Name:

Date of Birth:

Email:

Full Address and postcode:

Tel No (s):

Date of referral:

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:

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

Title:

Full Name:

Organisation Name:

Organisation Address:

Tel No (s):

Email:

Relationship to the person you are referring:

Date of referral:

Is the client aware referral is being made:

YesNO