Social Prescribing Referral

Arun & Chichester Citizens Advice Third Party Referral Form

Please use this form if you work for an organisation that supports clients and need to make a referral to our Social Prescribing service.

This form is only for clients who are patients of Fitzalan Medical Centre (including Wick surgery), The Coppice and Angmering Medical Centre. For all other surgeries, please speak to the surgery itself to make a referral.

Before completing the form, please ensure you have consent from the client to refer to the Arun & Chichester Citizens Advice Social Prescribing service.

In order to process the referral, the client's details will be added to our national online database system.

Our privacy policy is available on our website if the client wishes to understand more about how we will use and store their data.

If you are required to share special category data, e.g. health information, ethnicity, religion, etc. for the purposes of the referral, the client must give explicit consent and understand why this is necessary to be processed as part of the referral, as well as what information will be given to us.

Our business hours are Monday-Friday 9am-5pm and we aim to deal with all referrals within 2 business days