This form is for you to refer yourself, a family member, a friend or your client/patient to Age UK Lindsey's Services. In order to process the referral, Age UK Lindsey must collect personal data about you and/or your client/family member. For information about how your details are used and stored by Age UK Lindsey, please click here to read our privacy notice.
If you are referring on behalf of someone else, please ensure that you have received their permission to do so, before submitting their data, and that you complete your details in the relevant section.
All of our services have been adapted to continue providing support throughout the pandemic. There may occasionally be a short delay in responding to your enquiry due to changes in staffing and operating practices, but we will be in touch as soon as possible.
Thank you for your understanding