• Client Referral Form 

    Home Visit Advice and Support Service

  • The home visit service is for people over 60 and housebound, and who are unable to receive our support online or by phone, or to come to our main service in the Civic Centre, or to one of our outreach services.  It is for people who live in St Albans district only.

    We aim to contact all referrals within 3 working days. For most people this will be by phone. When we contact them by phone we may call from a withheld number.

    This form is for organisations to refer their service users or clients. If you are an individual and want to ask for a home visit - either for yourself or for someone else – please call us on 01727 811118. Lines are open Monday to Thursday 10am to 4pm, and Friday 10am to 1pm.

  • Eligibility for a home visit

  • Does the person live in St Albans district (their local council is St Albans City and District Council)?*
  • Age of Client*
  • Is the person able to receive our advice and support online or by phone, or to come to our main service in the Civic Centre, or to one of our outreach services?  Our outreach services are at Harpenden, Redbourn and Wheathampstead*
  • Why do they need a home visit to receive our support?*
  • What issues do they need help with?*

  • Risk information

    The person being referred 
  • Is there anything we need to know about the person to help us plan our visit?*
    Rows
  • Do they need someone with them at the appointment?*

  • Other people living in or visiting the property

  • Is anyone else living at the property or visiting regularly?*
    Rows

  • Home environment

  • Are there any dogs or other pets at the home?*
  • Could any of the dogs or other pets pose a risk when visiting the property?*
  • Does anyone smoke in the property?*
  • Overall, would you have any concerns about visiting this person at home?*

  • Client's Consent

  • Citizens Advice St Albans District needs to ask for some details about the client and the issue they need help with. We will use this information to provide them with advice as well as to improve our service and inform our campaigns. If you want more detail about their rights and how we use their information you can read our privacy policy on our website: www.citizensadvice.org.uk/myinformation https://citizensadvicestalbans.org.uk/privacy-policy/

  • The client has consented to this referral*

  • Client Details

  • Is it ok to leave a phone message?

  • Thank you for your information.

    Please click Submit to continue.

  • Should be Empty: