REFFERAL

Welcome to Our Referral Page

At BAME HUB-UK NETWORK C.I.C., our mission is to bridge the gap and improve communication between the UK mainstream and BAME communities, fostering a stronger and more inclusive society. Our referral form plays a crucial role in achieving this vision, as it allows us to extend our support and services to those who need it most.

Why Refer Service Users to Us?

• Social Cohesion and Inclusion: By referring individuals and families to our organisation, you contribute to advancing social cohesion and reducing isolation and social exclusion. Together, we can build stronger connections within our communities and promote a sense of belonging for everyone.
• Equality, Diversity, and Justice: Your referrals enable us to advocate for equality, diversity, and justice. Through our services, we strive to ensure that all individuals, regardless of their background, receive the support they deserve, fostering a fair and equitable society.
• Access to Support and Resources: Our referral form allows marginalised BAME groups to access essential support and resources. From legal advice on immigration and asylum matters to housing, financial assistance, healthcare, education, and domestic violence services, we are here to provide a comprehensive network of services.
• Empowerment and Skill Building: When you refer someone to us, you help equip BAME communities and their families with the skills they need to be self-sufficient. By avoiding pitfalls associated with a lack of empowerment and information, individuals can enhance their social standing and actively contribute to society.
• Mental Health and Well-being: Through our overall health and mental health support programs, we work to address the unique challenges faced by members of the BAME community. Referring individuals to these programs can have a profound impact on their well-being and quality of life.
• Job Creation and Empowerment: By referring individuals for mentorship, career development, and juvenile justice programs, you contribute to our goal of creating 3000 jobs across the UK. This empowers individuals to become financially independent and make a positive impact on their communities.
• Feeding Programs and Support: Your referrals help us provide essential support to vulnerable people, including asylum seekers, refugees, immigrants with limited public recourse, and those experiencing homelessness or mental health difficulties.
• Domestic Violence Services: We are committed to providing care, support, refuge, and sanctuary for victims of domestic abuse and violence. By referring individuals to our domestic violence services, you play a crucial role in ensuring their safety and well-being.

How to Use the Referral Form:

Our referral form is designed to be user-friendly and accessible to all. Whether you are making a self-referral or referring someone else, please complete the form with accurate and detailed information. This will enable us to tailor our support to meet the specific needs of each individual or organisation.

Remember, by referring service users to BAME HUB-UK NETWORK C.I.C., you become an integral part of our mission to foster understanding, cooperation, and collaboration within BAME communities and the UK mainstream.

Thank you for your dedication to creating a more empowered and inclusive society. Together, we can make a difference!

BAME HUB-UK NETWORK C.I.C Referral Form

- Step 1 of 5

Referral Type

• Self-Referral
• Professional/Organisation Referral

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Name *

First

Last

Organisation (if applicable): _

Email *

Phone

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Name *

First

Last

Date of Birth

GenderFemaleMalePrefer not to say

Ethnicity

• White British / White Irish
• Black, Black British, Caribbean or African
• Asian or Asian British
• Mixed or multiple ethnic groups
• Other ethnic group

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Email *

Phone

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Referral Reason and Requirements

Please provide a brief explanation of the reason for the referral and any specific requirements or support needed by the individual or organisation.

Languages (1st, 2nd preferred/ Is interpreter needed (give details including if they prefer same sex)

Including relevant evidence and documentation with the referral form can strengthen the case and provide valuable information. Here are some suggested types of evidence that could be important to include please select and upload

• Identification Documents: Copies of official identification documents (e.g., passport, driver's license) for both the referrer and the referee.
• Referrer's Letter: A detailed letter from the referrer explaining the reason for the referral, the relationship with the referee (if applicable), and any relevant background information
• Referee's Statement: If possible, a statement from the referee expressing their willingness to be referred and outlining their needs and expectations.
• Relevant Medical Records: If the referral is related to health or medical issues, any relevant medical records, diagnosis reports, or treatment plans
• Supporting Documents: Any supporting documents that provide context or evidence for the referral. This could include reports from social workers, counselors, or other professionals involved with the referee.
• Educational Records: If the referral is related to education or training, copies of educational records, certificates, or academic assessments.
• Legal Documents: If the referee is involved in any legal matters that relate to the referral, copies of relevant legal documents or court orders.
• Consent Forms: Copies of any consent forms signed by the referee, granting permission for sharing their information with BAME HUB-UK NETWORK C.I.C.
• Financial Information: If the referral is for financial support, any evidence of income, benefits, or financial circumstances that might be relevant
• Employment History: If the referral is related to employment support, the referee's employment history, CV/resume, or any relevant documents
• Other

File Upload

Click or drag a file to this area to upload.

Including relevant evidence and documentation with the referral form can strengthen the case and provide valuable information to us receiving the referral.

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Consent *

• Before making a referral, we require explicit written consent from the individual to be referred to ensure compliance with the UK General Data Protection Regulation 2020 (UK GDPR) and other relevant legislation in England & Wales. We will only use their information for the specific purposes for which consent was obtained, such as contacting them and sharing their details with relevant third parties to provide necessary support. Please note that without their explicit consent, we cannot proceed with the referral process. By checking this consent box, I confirm that I have obtained the necessary consent from the individual being referred or have informed them about the referral and that they agree to share their information with BAME HUB-UK NETWORK C.I.C for the purpose of accessing appropriate support and services.

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