NOTICE: REFERRAL PROCESS SUSPENDED. Due to a very high volume of referrals in recent months, the decision has been taken to suspend the referral process until further notice. Please consider whether Facilitated Friendships or Activites would be suitable for your client instead. 02/11/2022
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)