Coventry Support Service

Welcome to our online referral portal. If you need support with your referral, or have any questions, please call Freephone 0808 196 2660 (lines open Monday-Friday, 9am-5pm).

This helps us identify the right support for your circumstances.

Please select which service you require

If the above options don’t feel like they apply to you, then don’t worry – you still may be able to obtain similar support from another organisation. Please visit https://www.coventry.gov.uk/homelessness.

You can also call us free on 0808 196 2660 and we’ll help point you in the right direction.

This helps us identify the right support for your circumstances.

Please select the type of support required

Referral to this service must be made only by Coventry City Council.

Please enter your Coventry City Council email address, and department in order to continue.

You will be asked for further contact details later in this referral process.

Who are you making a referral for?

Please confirm you have the appropriate authority and consent to share the clients details with us for the purposes of providing them a support service. You must have this before you continue.

To confirm, please click the below button.

If you have previously received support from us, we can review previous records (only with your consent) to ensure we can pick-up from previous support provided.

Have youthey ever been referred to P3 or another Coventry Housing Related Support service before?

Please select the option that applies

Please select all options that apply to yourtheir circumstances.

We use this information to establish how best we can help you, and to ensure you meet the eligibility requirements to receive support from our service. This information is also used to allow us to prioritise your case based on the information and circumstances you provide.

We use your name in order to address you when responding to or contacting you about your referral.

We use your relationship to the individual information to monitor the sources of our referrals and to ensure we are aware of you as a key contact for the individual being referred.

We use organisation information to monitor the sources of our referrals and to help us contact you if we need to.

We use contact information to keep you informed about your referral, and/or to contact you to clarify or discuss any information you may have provided.

We use risk information to ensure our staff are fully aware of any circumstances that may require us to take appropriate steps to ensure the safety of our employees.

Referrer Details

Risks:

 

We use your name in order to address you when discussing your referral and any future correspondence or communication in relation to your support

We use date of birth information to ensure you are accessing the most appropriate service for your needs and circumstances.

We use contact information to make contact about the assessment and support. By adding your contact details, you consent to us using them for the purposes of processing your referral and/or providing you with a support package.

We’ll do our best to make sure we contact you using the most convenient method and at the most convenient time

If you’re happy for us to leave a voicemail on the numbers you have provided, please provide your consent. If you don’t, we’ll still call you – but we won’t leave a voicemail.

YourTheir Details

Please note, if you are referring a family to this service, please complete the following fields with a single appropriate contact (over 18) within the family.

YourTheir date of birth

Please enter in the boxes below

What is yourtheir best contact? Please provide one or more of the requested contact details:

Which is yourtheir preferred contact method?

Contact Time – when is the best time to contact youthem?

Are you happy for us to leave a voicemail?

YourTheir accommodation status:

We use your address as the primary place to visit you to provide support and/or to send relevant correspondence if required.

YourTheir Current Address

Does anyone else live at this address?

We use language preference information to ensure we communicate with you in the correct language, and that you understand any documentation or conversations that we may have

We use accessibility needs information to ensure we can adapt our service, support, and contact arrangements to fit any accessibility requirements you may have.

Preferred Language

Do theyyou have any communication needs?

 

We use this information to allow us to understand what it is you need help with, and to ensure we can correctly prioritise you if a waiting list is currently in operation.

Their CircumstancesYour circumstances

Please select any other circumstances that currently apply

We use this information to allow us to understand the reasons behind the need for support from our service.

Please briefly explain the main reason(s) you feel support is needed:

We use this information to allow us to plan future support requirements and ensure you are receiving all of the support you are entitled to based on your circumstances.

TheirYour current income support

– please select which types of income currently apply

We use next of kin information as part of our safeguarding procedures, if have concerns or in the event of an emergency we may be required to reach out to a next of kin.

We use the (optional) information about other organisations involvement to make contact with professionals with whom you are already involved with, to ensure we compliment any existing support you may be receiving and to prevent duplication or repetition.

Others involved

If we are unable to contact youthe individual being referred directly, we can get in touch with a nominated secondary contact

Can we contact this person if we are unable to reach the individualyou directly?

Are there any other organisations or professionals involved in supporting the personyou?

Data Consent

Please read and accept your understanding of our Privacy Statement which can be found here.

Feedback

Please rate your experience of this referral process

To what extent do you feel that this referral portal was easy to use?

Do you have any further comments or suggestions about our referral process?

 

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