Referral

Make a Referral

How to Access Our Services

We know that arranging care, whether for yourself, a loved one, or someone you support professionally – can feel like a big step.

You might be feeling overwhelmed with information, unsure where to start, or simply need someone to listen and guide you through the process. That’s exactly what we’re here for.

If you’d like to access one of our services, the first step is easy: just get in touch. You can fill in the referral form below, and one of our amazing team will contact you to talk things through.

We’ll take the time to understand your situation, answer any questions you have, and explain what support might look like for you.

We accept referrals from:

  • Individuals and families
  • Healthcare professionals
  • Social workers and Local Authorities
  • Hospital discharge teams
  • Charities and community organisations

 

You don’t need to have everything figured out before you speak to us – we can help assess needs, explore funding options, and guide you through the next steps.

If you’d prefer, you can also reach us directly:

📧 Email: info@aqthomecare.co.uk

📞 Call: 020 8531 5239

Whether your referral is for complex care, supported living, or help at home, we’ll respond promptly, treat your enquiry with sensitivity, and work with you to put the right support in place as quickly as possible.

Referral Form

Personal Details of Individual
Personal Details of the Person Making the Referral
Contact Details of Social Worker/Care Manager (where known)
Service Requirement Information
Funding Information
Overview of the Individual Requiring Care and/or Support
Medical Conditions
Are there behaviours or difficulties of concern?
Areas of Care and/or Support
Please tick the relevant column to give us an idea of the levels of support needed
Agreement
By signing this form, you are confirming that, to the best of your knowledge, the information provided is correct regarding the needs on the individual being referred.