Referral Form
This referral form helps me understand your needs and ensure that I’m the right fit to support you. You’re welcome to complete as much or as little as you feel comfortable with — it’s okay to leave sections blank if you’re unsure or would prefer to discuss things later.
I work in a trauma‑informed, client‑led way, and your safety, preferences, and pace are always respected. The information you share here is kept private and is only used to help determine whether my services are the right match for your situation.
If you’re a referrer completing this on someone’s behalf, please include the participant’s preferences wherever possible.
If you would prefer to talk through the referral instead of completing the form, you’re welcome to contact me directly.
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Once your referral is received, I’ll be in touch to discuss next steps and make sure the support aligns with your goals and needs.
Current Capacity
I currently have no capacity for new Specialist Support Coordination (Level 3) participants.
All other services — Support Coordination (Level 2), Support Connection, and Psychosocial Recovery Coaching — remain open for referral.
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If you need help completing this form
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If completing forms is difficult, overwhelming, or not accessible for you, please let me know. I’m very happy to support you to complete the referral in a way that works best — over the phone, through email, or in a slower, step‑by‑step conversation.
Once your referral is received, I’ll be in touch to discuss next steps and make sure the support aligns with your goals and needs.