Make a Referral

If you are interested in employing your own Personal Assistants and would like to use our services, please complete the referral form below.

Person requiring support
Contact Person/Employer
Name of Professional
Additional Information

If you would like to include additional information with the referral or an SS2 Costing (Adults & Health), please email this to [email protected]

Equality Monitoring

We would appreciate it if you could complete the equality monitoring questions below. This will help us to know who has responded to this public engagement. The information you provide will be treated in the strictest confidence and in accordance with the General Data Protection Regulation 2018.


Please indicate which best describes your ethnic origin