London and National Professional Advice and Advocacy Referral Form

This form is for professional use only. For self-referrals please call 0808 802 0300.

Please note, submission of a referral form does not grant access to advocacy services. We do not operate a waiting list.

In sharing any personal details, you are confirming that you have the full, informed consent of the client to share their information with the National Stalking Helpline, and that they understand how we will store and process their data. Full details of how we handle personal data can be found at https://www.suzylamplugh.org/privacy-policy. Should you or the client require the privacy policy in a different format, please contact the Trust by phone on 0207 091 0014 or emailing [email protected]

Referrer’s Details
Details of case you are referring
Details of Stalker (if known)
Reason for referral