This referral has NOT been sent yet. You will be redirected to the listing's external referral form. Please complete the referral form there to submit the referral confirm Details Torch by Torch Help Hub I am signing up myself I am referring someone else Service access criteria Tick to confirm you have checked the service access criteria "We aim to support anyone within the greater Reading area who has an unmet need and no means of getting help to resolve the issue. We expect referrers and clients to have exhausted other available means of support and there to be no financial means to pay for the help. We do not seek to take on requests that can be better met by other organisations. When completing the section: "Additional referral details - What are the reasons for this referral?", please prioritise and select the most important reason. You can make a second referral if there is a another separate high priority reason for a referral. Please contact us directly on 0118 380 0260 if you have any queries." Your Details First name Last name Known as Date of birth Email Don't know / client doesn't have an email address Email is invalid We already have an account with this email. Please log in. Password Reset my password Log in Phone Address Line 1 Address Line 2 Town/City Postcode GP surgery NHS number Ethnicity SelectEnglish, Welsh, Scottish, Northern Irish or British Irish Gypsy or Irish Traveller Any other White backgroundWhite and Black Caribbean White and Black African White and Asian Any other Mixed or Multiple ethnic backgroundIndian Pakistani Bangladeshi Chinese Any other Asian backgroundAfrican Caribbean Any other Black, African or Caribbean backgroundArab Any other ethnic groupPrefer not to say Gender SelectFemale Male Transgender female Transgender male Non-binary Intersex Not specified Not known Other Additional referral details What are the reasons for this referral? Urgent help (e.g. help with shopping, picking up prescriptions) Enhanced Wellbeing (e.g. friendly support such as chatting or praying) Confidence Building (e.g. help with social re-engagement and getting out) Practical Tasks fixing stuff (e.g. basic DIY and painting) Practical Tasks outside the home (e.g. gardening/tidy up) Practical Tasks transporting things (e.g. goods ,furniture and rubbish) Practical Tasks cleaning inside (e.g. cleaning tidying, decluttering) Personal Help with paperwork (e.g. CVs, forms, bills) Personal Help with IT related (e.g. phones, laptops, online shopping) Personal Help with general assistance Advocacy (e.g. support at important appointments) Other: This field is required. Should the service provider be aware of any additional needs? Blind/partially blind Memory problem Hearing loss Housebound Does not speak English Poor mobility Learning and communication needs Physical disability Frail Other: This field is required. Please share some brief details regarding this referral Are there any other organisations already helping or is there any family, friends or neighbours who might be able to help? If yes, please provide details below in Other Information. Yes No This field is required. In order for Torch to provide the best service please indicate below any known physical or learning disabilities, poor mental health, or any other special requirements we need to be aware of. Please indicate below if anyone the volunteer may meet has a history of substance abuse or challenging behaviour (abusive, threatening or violent). For the purposes of visiting the home please confirm if anyone the volunteer may meet is a smoker, if there are pets or if there is anything else they should be aware of. For the purposes of visiting the home please confirm if there is safe access and free parking close to the home. Please let us know if there are any other significant risks a volunteer may encounter such as infestations, rodents, hygiene issues etc. Please confirm that Torch is free to select a volunteer to help of any gender. Please confirm if you are aware if a Safeguarding referral has already been made. Other Information: Please provide the referrers phone number and any other relevant information here., otherwise sat Not Applicable Tick to confirm if photographs can be/have been provided. Photographs will greatly help us evaluate practical tasks such as DIY, painting, gardening, rubbish removal etc. Please email these to help@torchhub.org.uk Tick to confirm that you give/have gained consent for Torch to make contact or send further information from time to time that may be of interest via text, email or post. Tick to confirm that you give/have gained consent for Torch Help Hub to share details given above with staff, volunteers and partners as necessary to respond to this referral in line with their Privacy Policy. Confirmation and consent Tick to confirm you consent to share this information with the service provider and Joy Tick to confirm you consent to the service provider contacting you directly Would you like to create an account? Make referrals faster next time you use Joy. Registered users can message service providers, submit reviews and track the progress of their referrals online. Password Weak password! Use at least 8 characters Use upper and lowercase characters (a-z) Use 1 or more numbers (0-9) Confirm password Please enter the same value again. required Submit Email: Password: Email
