STARS Online Referral Form – Refer To STARS

Please complete this form to refer someone to our service

About The Referrer

About The Person You are Referring

Contact

Only supply contact information that is safe for us to use. Please supply at least one contact method

More Information

Support Needs

Please note that if accessing our Counselling service STARS Dorset advises that people using substances or alcohol should be free of use for a minimum of one year. This is to enable them to get the most from the therapy. To find out more about services that can support you please speak with your GP or click here. ISVA services are available for those actively using drugs or alcohol.

Why are you seeking support from STARS Dorset?

In this next section we will ask you about the reasons you are seeking support on behalf of the client.

Please note you do not have to report to the police to receive support from STARS Dorset.

Safety

Please tell us about the clients safety: