Merton Uplift Self Referral Form
Brief questions to help understand the support that would suit you.
Please let us know if you want support to complete the form.
Confidentiality : Just so you know – if in working with us we become aware that you or a 3rd party is at risk then we will need to inform relevant agencies to ensure that the right support is provided.
(e.g. physical health issues, sign language, travel, concerns regarding your safety, interpreter [specify preferred language], relative/friend speak on your behalf – please provide the name)