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Referral Form

If you would like to refer someone to our advice service please complete the form below. We will either make contact with the client directly or book them an appointment to be seen by a caseworker. We aim to contact all clients referred via this form by phone within 3 working days. Please let your client know that our number will appear as withheld when we call.

We will notify you on the telephone number you provide if we are unable to make contact with your client. You will receive a confirmation email when you submit the referral using the form below.


    Please confirm you have permission to refer your client to Citizens Advice? (required)

    Yes

    By ticking this box you are confirming you have permission to pass on the personal details of your client and that you have obtained your client’s explicit consent to share their Special Category Data with us, as per the requirements of the General Data Protection Regulation (GDPR) 2018, where this applies








    Client Details





    Put 'none' if not known


    Put 'none' if not known