RESS Floating Support

Referral Form

Person-led support, advice and signposting for people experiencing or at risk of homelessness as a result of their immigration status.
This form can be completed by a person with restricted eligibility looking for floating support or by an agency supporting that person.

If you are completing this form on paper please email it to ress-referralsgm@boothcentre.org.uk
Who can access this support?

This service is for Non-UK Nationals with restricted eligibility
- You should be over the age of 18
- Couples can be referred, as well as single people
- Offending history is not a barrier to RESS Floating Support
- We will support people who are risk of homelessness or are experiencing homelessness
- You should be currently located in Manchester or Greater Manchester
- This support service is not suitable for families
Who is completing this form?

Please let us know if you or someone helping you is completing this form.
I am...

Looking for Floating SupportSupporting a person who is looking for Floating SupportA friend or family member of the person looking for Floating SupportOther

Are you completing this form for someone else?

If you are completing this form for yourself, please go to the next page
Referrer's Name

First NameLast Name
Contact Number

Area CodePhone Number
Contact Email
example@example.com
How do you know the person?
If you work for a support agency, please include details of the organisation

Your details

This information will help us communicate with you in the best way
Name

First NameLast Name
Phone Number

Area CodePhone Number
Which area of Greater Manchester are you staying in, or have stayed in most recently?
e.g. Salford, Manchester, Tameside.
Email
example@example.com
Your date of birth

DayMonthYear
What is your nationality?
What is your gender?
If you would prefer not to say, you can leave this blank
Do you need an interpreter for conversations in English?
What language do you prefer to use?

Tell us about your immigration status

This will help us learn about how we could best support you
Tell us about your current immigration status and how this is affecting your current housing situation
Please include details of anyone who is supporting you with your current immigration case.
If you currently have representation for your immigration case, please give us their full details

Tell us about you

We'd love to hear about what you want to achieve and how we can help
What do you want to achieve with the help of Floating Support?
For example you want to find accommodation or you want to improve your English

Anything else you think we should know?

This will help us make sure the support you get is right for you
Do you have any health conditions?
E.g. physical or mental health conditions
Do you have substance misuse issues?
E.g. alcohol
Do you have criminal convictions that have made it difficult to get help?

YesNoNot sure
Do you have a support worker? If yes, please tell us their details
Name, contact information and where they work

I give consent for information on this referral form to be shared with GMIAU, Boaz and Booth Centre

Yes
Date

DayMonthYear
Date you gave consent
Should be Empty:

Referral Form