Make a homeless or support referral

This form is for public authorities and other organisations to refer someone that they believe is homeless or threatened with homeless (often called a Duty to Refer).

You can also refer someone who needs early intervention support from our Wellbeing Options Team.

Your information is stored and sent securely to help keep it confidential. Please read our privacy policy.

About this form

This form is intelligent - questions and whole sections may appear or disappear as you answer, so you only see what's relevant to you.

Each page is saved when you continue, so you can leave the form and come back at any time.