Christmas Professional Referral

This Referral Form should be filled and submitted by a midwife, health visitor, social worker, or other front-line professional.  You may include all family members permanently living at the address.

The closing date for referrals is Sunday 26th November 2023. 

Due to the expected high demand this year, we ask that our Professional Referrers collect their referrals on a pre-arranged collection date. This is to help us ensure all deliveries are made in time for Christmas! 

Here’s how it will work:

  1. Please refer all the families that you know are in need of support this Christmas by 26th November. 
  2. We will call you to arrange your collection date. This will be the date for you to collect your referrals from our Ellesmere Port Christmas Hub based at Appleton Drive, Whitby, Ellesmere Port, CH65 7EP.
  3. We will prepare all of your referrals ready for your collection date.
  4. You can then collect and deliver to your families in time for Christmas!

Christmas Professional Referral Form

Referrals are NOW OPEN until 26th November 2023

Christmas Referral Form

"*" indicates required fields

1About You
2About the Family
3What is Needed?
4Equal Opportunities & Consent
Referrer's Organisation Address*