Referral form: Community services

If you are making a referral on behalf of someone else, please read the following information before completing our referral form.

Our support is always subject to capacity and the location of the woman being referred.

• We are only able to offer support to women in the community in London.
• It can take at least 2-3 weeks for us to review a referral and start the process of offering support.
• We will always do our best to offer support, but it is difficult for us to respond quickly to urgent referrals and there is more chance of this if we receive the referral earlier in a woman’s pregnancy.
• We aim to work as collaboratively as possible with referrers and recognise the skills and opportunities referrers have to co-support women accessing our services.

Before referring a woman to Birth Companions please consider the following:

We recommend that you complete this form whilst you are with the woman you are referring.

• Please ensure you have consent from the woman to make a referral to us. 
  As part of asking for her consent please ensure she understands that you will be sharing information with us about her personal history and circumstances which will help us to make sure the support we offer is appropriate for her specific need and situation. 
• Ensure the woman being referred understands the support and services Birth Companions may be able to offer her.
  If a woman has a clear understanding of the of support we can offer her, she will feel better informed to decide whether this is the right support for her.
• Ensure the woman being referred understands that she can choose to accept our support in a way that works for her.
  When a woman does not feel under pressure to commit to something specific and understands that she can choose how and when to engage with our services, we believe she will be more likely to accept our support.
  That is why we ask all referrers to explain to the women they refer to us that our service is flexibility, based on her needs and it is her choice whether to engage with us or not.
• Please ensure that the woman you are referring knows we will contact her directly if we are able to support her.
  This will help her to feel prepared and willing to speak to the Service Coordinator when they contact her.
• When filling in this form please ensure that the information you provide is accurate. 
  Accurate contact details, date of birth, expected due date and the hospital where a woman is registered are particularly important to help us to process a referral as quickly as possible.

What will happen next?

We usually review referrals every two weeks so it can take up to 3 weeks for us to be able to start supporting someone.

• After submitting a referral form to Birth Companions, you will receive an email to confirm we have received the referral. 
  If we can offer support to the woman referred, one of our Services Coordinators will contact her directly.
  Please explain this in advance to her to help her to feel prepared and willing to speak to the Service Coordinator when they contact her. 
  You can also reassure her that our Service Coordinators are all female, will always introduce themselves by name and will say they are from Birth Companions.

• Once a woman successfully begins to access our support, we will send you an email update to confirm this.
  If required, we  can also provide more detailed updates to help facilitate a collaborative approach to offering support. 
• If a woman decides not to accept our offer of support or we are unable to make contact with her, we will email to update you to discuss possible next steps or to agree close the referral.

Complete referral form

If you have any problems submitting your form please email us.

If you wish to refer a woman supported by the Advance WrapAround service 
to our Community perinatal support - Criminal Justice Service, please go to
our Community perinatal support - Criminal Justice referral form.