Client Self-Referral Form
For Birchtree Housing CIC to be able to assess the client holistically, ensuring that all elements are considered, it is vitally important to have all of the relevant information about the client’s needs, and wants. This will enable the client to be placed in the right environment, and provided with the individual support they will need to firstly sustain their accommodation, adhere to their licence and to develop the skills they need to eventually when ready to move on to being fully independent, in the community.
Please note: All clients will have a 30 day probation period to ensure that the service is the most appropriate for them.
This form to be used only for Birchtree Housing CIC referrals:
Guidance and information:
- Please give clear information about the client
- Please attach the required documents listed below to the automated reply email you receive once the form has been submitted
- We aim to respond within 72 hours
Documents required:
- Proof of ID
- Proof of Benefits
- Proof of National Insurance number
- 1 month bank statement
- If in employment (please provide payslips)
Birchtree Housing CIC
Telephone: 020 8191 8797
Email: info@birchtree.care