Rosemount Services Referral Form
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  • Are you a self-referral or a professional?*
    • Self-referral section 
    • Are you:*
    •  - -
    • Format: (0000) 000-0000.

    • We will send you notifications and keep you updated*
    • What do I want from Rosemount Lifelong Learning (RLL)?*
    • If section  
    • Would I like to be referred to a mentor who can help me make the most of accessing support?*

    • A bit about you (optional)

    • Have you experiencing any of the following issues (or have in the past 2 years)*
    • Professional section 

    • Details of person being referred

    • Are they:*
    •  - -
    • Format: (0000) 000-0000.

    • Confirmation they are aware of the referral*

    • Referral

    • Format: (0000) 000-0000.
    • What services or support do referees seek from Rosemount Lifelong Learning (RLL)?*
    • Submit section 
    • Sharing my information*

    • Confidentiality Statement


      Rosemount Lifelong Learning treats all personal information provided through this referral system as confidential. Information will only be used for the purpose of assessing and supporting the referral and will be accessed only by authorised staff who need the information to provide appropriate support. Information may be shared internally within Rosemount Lifelong Learning on a need-to-know basis to ensure safe and effective service delivery. 

      We will not share information with external organisations without the individual’s consent, unless there is a safeguarding concern, a risk of harm, or a legal requirement to do so. 

      All information is handled in accordance with UK GDPR and the Data Protection Act 2018 and stored securely.

      If you have any questions about how information is used, please contact Rosemount Lifelong Learning.

    • Submit section referral 

    • Confidentiality Statement


      Rosemount Lifelong Learning treats all personal information provided through this referral system as confidential. Information will only be used for the purpose of assessing and supporting the referral and will be accessed only by authorised staff who need the information to provide appropriate support. Information may be shared internally within Rosemount Lifelong Learning on a need-to-know basis to ensure safe and effective service delivery. 

      We will not share information with external organisations without the individual’s consent, unless there is a safeguarding concern, a risk of harm, or a legal requirement to do so. 

      All information is handled in accordance with UK GDPR and the Data Protection Act 2018 and stored securely.

      If you have any questions about how information is used, please contact Rosemount Lifelong Learning.

       

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