Your journey starts here

Whether you’re referring a friend, family member, neighbour or yourself, Crossroads is here for you.

Have a read through the FAQ and then proceed to the Referral Form below. If you have any questions, don’t hesitate to contact us - we’d be happy to help.

Frequently Asked Questions

  • If you’re a Professional looking to refer a Service User to Crossroads, please use our dedicated Professional Referral form instead.

    While this Self-Referral form is slightly quicker to complete, it does not capture the information required for professional community referrals. If the Professional Referrals form is not used, we may be contractually unable to contact the individual(s) requiring support, which could delay or prevent them from being offered our service. Thank you for your cooperation.

  • If you are finding this form difficult to fill out for any reason, give us a call on 01462 455578 and our friendly team can take the details over the phone for you instead.

  • We take GDPR and data privacy seriously here at Crossroads. View our Privacy Policy.

Self-Referral Form:

This form is split into 3 sections: Services, Main Carer details and Cared For (Client) details.

Once you click ‘Submit’ at the end, our friendly team aims to be in touch within 2 working days.