Centrum Care Homes Refer a Resident
Please complete this simple form to provide us with the details of a friend or family member you would like to recommend Centrum Care Homes to. In return, you will receive a £250 Gift Voucher if your friend or family member moves into one of our homes.
Your name
*
First Name
Last Name
Your email address
*
example@example.com
Care Home you are referring for
*
Please Select
Beacon House
Croft Lodge
Estuary View
The White House
Windward House
Willow House
The name of the resident you would like to refer to move into one of our homes
*
First Name
Last Name
The best person to speak to about this resident
The best contact phone number to speak about the resident
*
Please enter a valid phone number.
How you know this person
Date of referral
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: