If you a work for a partner agency and you would like to refer a customer to WIN Independent Living and Wellbeing in the Community, please complete the form below.
1. Mobility and independence
In order to access our service, individuals need to be able to leave their property and access the community. (Unfortunately we are unable to provide any physical support or personal care needed).
Sometimes the information on this form is all we have to work with and our team work independently out in the community. Please include anything you feel is relevant for someone to know who may be working 1:1 in an individual’s home. A risk assessment may also be required on request in certain cases.
The information provided is confidential and will be used to process the referral accurately and efficiently. Please complete the form fully.