I Need Help Make a Referral Referral Form Privacy Notice The GDPR provides individuals 8 limited rights: Right to be informed, Right to access their information held Right to rectification of incorrect information Right to be forgotten Right to restrict processing Right to data portability Right to object to processing And rights in relation to automated decision making and profiling Please see the data protection policy for details. By sharing information, you are consenting to the processing of that information. All information provided may be shared between the counselling, one to one, and/or admin teams as required. To be able to access these services we need address or telephone to be able to contact you, age to ensure eligibility to the service, and risk factors for safeguarding. You have the right to withdraw consent of this information at any point, however please see below for the consequences of this action. If at any point you’d like to lodge any complaint regarding the use of data, please don’t hesitate to contact the Data Protection Officer. All data provided will be retained for a specific period of time after the end of a project. You will need to ask a staff member for exactly how long that would be as it varies by funder. Purpose Compulsory information? What happens if you refuse? Name Required to identify application No Can’t be referred Address Required to inform applicant of written information No Either address or telephone must be given to be referred Telephone Required to contact applicant re. appointments No Either address or telephone must be given to be referred Email Alternative contact option No None D.O.B. Identification, safeguarding, and ensuring minimum age for service No Can’t be referred ICE Contact Reach contact in emergency No None Referred to Required for client allocation No None Self-Disclosed Problems/Needs Required for client allocation No None Self-Disclosed Risk Factors Required for risk assessment No Can’t be referred Additional Support Knowing this allows us to avoid duplicating work with other organisations No None Manage Cookie Preferences