Referral Forms

Please use the following links to download the Referral Forms for our services:

• Get Up And Go: Referral Form 

Email the completed form to: getupandgoservice@ageuktameside.com

• Step Up Falls Prevention: Referral Form

Email the completed form to: customerservice@ageuktameside.com

• Information and Advice: Referral Form

Email the completed form to: info&advice@ageuktameside.com

• Be Well Community Support: Referral Form

Email the completed form to: customerservice@ageuktameside.com

• Dementia Support: Referral Form

Email the completed form to: customerservice@ageuktameside.com

• 131 Social Club: Membership Form

Email the completed form to: customerservice@ageuktameside.com

• Blokes and Brews: Registration Form

Email the completed form to: customerservice@ageuktameside.com 

• Studio 131: Membership Form and Disclaimer

Email the completed forms to: customerservice@ageuktameside.com

• Mental Health STAR Service:

For referrals into this service please see the Mental Health STAR Service page.

Referrals can be made from the Whittaker Day Hospital, Community Mental Health Teams, Action Together Social Prescribers, GP’s and the Fire Service.