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Ecas

Friendly and practical help for people with a physical disability

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Befriending referral form

This service is primarily in response to Covid-19 and aims to provide temporary and time-limited support to those who have been more effected by isolation. While some clients may be able to meet their Befrienders in person in the future, this is not something we can guarantee.

Client Data Protection Notice:

Ecas will use the information supplied on this form, including information about the client’s health to assess their eligibility and to administer our client records.

By returning this form, the client has consented to Ecas processing their data for those purposes.

Please ensure you have read the referral criteria before completing this form.

Download application form (Word document)

  • Referring Agent

  • Name * REQUIRED
  • Address * REQUIRED
  • Client

  • Name * REQUIRED
  • Date Format: DD slash MM slash YYYY
  • Address * REQUIRED
  • Please let us know how best to get in contact with the client
  • Details of disability

  • Please include description of any mobility aids used
  • Please give specific reference to any isolation issues
  • (e.g. WhatsApp voice/video, Zoom video calls, etc.)
  • This field is for validation purposes and should be left unchanged.

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Befriending

  • Become a volunteer befriender
  • Befriending opportunities
  • Befriender’s role
  • About befriending
  • Facilitated friendships
  • Make a referral

Any questions?

No question is a stupid question. Head over to our Frequently Asked Questions and if you can’t find the answer give us a call or email and we’ll be happy to help.

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Get in touch with us and we can tell you more about Ecas.
  • Your Name
  • This field is for validation purposes and should be left unchanged.
Copyright © 2018 Ecas. Ltd. Registered in Scotland No. 102790. Registered charity No. SC014929. Registered office: Norton Park, 57 Albion Road, Edinburgh EH7 5QY
Scottish Charity Regulator
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