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Make a Referral - Out of the Blue

If someone you support is interested in attending, please fill in the referral form below. You can be referred by your GP, keyworker, CPN or support worker or individuals can refer themselves.

Your information will be sent securely to the team at HOOT who will be in touch to make sure we have everything we need and to invite you to sessions. We will call or text you from 01484 516224 or 07880 731767.

If you’re not sure which sessions you might like to attend, you can check out the ‘What’s On’ page to see what is happening in the groups or call us on 01484 516224 to chat with a member of staff about what’s currently on offer.

The Clients Details
By telling us how you heard about HOOT and our sessions you will be helping us to evaluate our publicity and marketing and make changes to improve visibility and accessibility.
The Clients Emergency Contact Details
HOOT may contact your client's emergency contact if we have concerns regarding their health whilst attending the service. Please ask your client to inform their emergency contact that their details have been given to HOOT for this purpose.
The Clients Keyworker Details
HOOT may contact your client's Key Worker to ensure we are providing the best service for them and/or if we have concerns regarding their health.
The Clients Doctor's Details
HOOT may contact your client's doctor if they do not have a key worker, to ensure we are providing the best service to them and/or if we have concerns regarding their health.
Please also identify if your client has a diagnosis of and/or identifies as having Autism/Asperger's, dementia, a learning disability and/or a hidden disability.
Your Details
Your Organisation
Risk Factors

The data submitted on this form will be stored securely in Hoot Creative Arts' database in order to process your referral and contact you with regards to attending sessions. 

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