Referral form
Response and Mind share a referral form for applications for supported housing and support. Referrals are accepted from health, social care, and local authority organisations where longer-term placements and support are being sought for individuals.
We are unable to accept self-referrals.
We kindly ask that you answer all questions as fully as possible, so we can ensure you receive the most appropriate assistance. If this is your first time completing the form please read the guidance below.
Please note that it is not currently possible to save the form while completing it. However, once submitted, you will be able to download a copy for your records.
We are unable to accept self-referrals. If you need to access support for yourself, please visit our Get urgent help page.
We accept referrals from:
- applicants who have a diagnosed mental health condition
- individuals who require enhanced or focused support
- support agencies referring on behalf of an individual.
We cannot accept:
- self-referrals
- referrals from friends and family
- referrals from GPs.
What to prepare before you begin your referral
Before beginning this referral, please ensure you have the following paperwork available to send to us. A referral will not be processed until we have all of the information.
For referrals from the AMHT, SFCT, EIS, Keystone Hubs or OACEDS
We require:
- a care plan
- a risk assessment
- a Care Act Assessment or 117 Assessment*
- completed budgeting tool
- a signed consent form, with wet (handwritten) or digital signature.
*If applying for 24-hour services, a Care Act Assessment or 117 Assessment is mandatory. If applying for transitional services, it is beneficial, but not required unless the applicant is currently admitted to a ward. If you are supplying a Care Act or 117 Assessment, please check which parts of the form you need to complete.
For referrals from Adult Social Care
We require:
- a Care Act Assessment
- a GP summary, GP letter or AMHT assessment with a clear, active, mental health diagnosis listed.
- a risk assessment (if available)*
- a completed budgeting tool
- a signed consent form, with wet (handwritten) or digital signature.
*Referrals for an applicant currently under probation require a risk assessment.
For referrals from other agencies
Including: Out of Hospital Teams, the Adult Homeless Pathway, local authority housing departments, social prescribers and probation.
We require:
- a care plan (if available)
- a risk assessment (if available)*
- a GP summary, GP letter detailing a clear, active mental health diagnosis or AMHT assessment with a clear diagnosis
- a completed budgeting tool
- a signed consent form, with wet (handwritten) or digital signature.
*Referrals from probation departments or where the applicant is currently under probation require a risk assessment.
Contact us
If you have any questions or need help completing the form, please don’t hesitate to contact us at referrals@response.org.uk.
We’re here to support you.