Enquiries and referrals
Women can self-refer into this service by contacting us here. Professionals who are working with or supporting someone they would like to refer to us can do so using our referral form here. You can get in touch with us to make an enquiry by ringing the Eve’s Space team on 01204 385848. Or you can email us on admin@urbanoutreach.co.uk
Please note that for reasons of security, personal information should not be shared through our admin email address.
PLEASE READ THIS FIRST
You will need to be speaking with your service user in order to complete this referral form. Eve’s Space is a free ‘women only’ service offering a safe and relaxing place where those experiencing difficulties which places them at risk of offending or re-offending, or of becoming a victim of crime, can get help and support. Our specialist female support workers can help with:
- Family and relationship issues
- Drug and alcohol issues
- Access to education, training, volunteering and employment
- Money, benefits and debt problems
- Housing
- Registering with a doctor or dentist
- Support to overcome emotional or health difficulties
Our Eve’s Space service is for women living in Bolton. However, we are part of a network of women’s centres working across Greater Manchester. If the person you wish to refer lives outside the borough of Bolton you should contact the Greater Manchester Women’s Support Alliance for help and support. Go to www.gmwsa.co.uk for more information.
Only professionals who are currently supporting a the woman concerned should use this referral form. If you are unsure about any of this, please ring the Eve’s Space team on 01204 385848 or email us on admin@urbanoutreach.co.uk before completing this form.
All fields marked with an (*) will require completion.
| Please list all client’s children (under 18) | Status: | ||||
|---|---|---|---|---|---|
| First and last name: | Date of Birth: | At home | In care | Living with relatives |
Mixed care |
Please indicate the reasons for your referral by checking the boxes of all needs or areas of concern that apply to your service user. This information is needed so we can assess if and how we can help. For each one checked, please provide a little information as to the specific need or concern. If none of the categories listed apply to your client, please contact us to discuss further.
| Client’s need(s) or area(s) of concern |
Summarise how this need or concern applies to your client |
||
|---|---|---|---|
| 1 | Education / Employment / Training / Volunteering |
||
| 2 | Drugs / alcohol | ||
| 3 | Accommodation | ||
| 4 | Mental Health / Wellbeing |
||
| 5 | Physical Health | ||
| 6 | Attitudes / Thinking / Behaviour |
||
| 7 | Finance / Benefits / Debt |
||
| 8 | Domestic / Sexual Abuse |
||
| 9 | Sex Work | ||
| 10 | Children and Families |
||
We now need to consider what the risks of harm are to your service user, arising from her circumstances.
| Risks of harm to your service user |
Summarise how this risk of harm applies to your service user |
||
|---|---|---|---|
| 1 | Substance Misuse | ||
| 2 | Self-Harm | ||
| 3 | Suicide (thoughts / attempts) |
||
| 4 | Domestic / Sexual Violence |
||
| 5 | Sex Work | ||
| 6 | Other (please specify) |
||
Finally, we need to consider what the risks of harm are to others, arising from your service user.
| Risks of harm to others | Summarise how this risk of harm applies to others (i.e., staff, family members, other service users, volunteers, members of the public) |
||
|---|---|---|---|
| 1 | Verbal Abuse | ||
| 2 | Aggression or Violence |
||
| 3 | Anti-Social Behaviour |
||
| 4 | Financial Abuse of Others |
||
| 5 | Victimisation / Bullying |
||
| 6 | Racial Abuse | ||
| 7 | Parenting / Children | ||
| 8 | Other (please specify) |
||
* PRIVACY & DATA SECURITY Please now read this statement out to your service user and confirm the following: Eve’s Space is a service provided by Urban Outreach Bolton which is a registered charity. Please now confirm that the personal information you have just given me is correct. This information will be held securely by Urban Outreach solely for the purpose of managing the Eve’s Space service. If you accept help and support from Eve’s Space, your personal information will need to be shared in confidence with other professional agencies to provide the support, help and protection that will be needed. |
WHAT NEXT…
We aim to process your referral and get back to you within 48 hours. If your referral is not taken forward, we will give the reason(s) why. This will either be because your client:
- does not live within the area we cover, or
- is already supported by us through another referral route, or
- presents an unmanageable safety concern, or
- presents with needs or concerns that would be better supported through another specialist agency.
If your referral is accepted, we will:
- let you know what we are doing, and
- contact your client directly to make arrangements for an initial meeting and assessment.
