Refuge Referral Form
Please Fill in the form Below
How to complete this referral:
By completing this referral form, you’re helping us to contact the client as safely and quickly as possible. We’d appreciate it if you could include as much information as possible – this saves the client from being asked the same questions twice and helps us to understand more about their needs and circumstances.
Eligibility criteria for this service:
Please be sure to check that the client meets the following criteria before making the referral:
All PDAP accommodation is for any women aged 16 or above with or without children fleeing domestic abuse.
Please attach the following documents to this referral, if completed:
- Recent DASH risk assessment (if one has been done)
- Proof of immigration status or recourse to public funds. How to get in touch:If you have any questions about our service, eligibility criteria, or how to make a referral, please contact PDAP’s 24 hr Helpline 0800 052 7222