Referral Form

All information given will be kept in strict confidence and only given to the allocated SOLACE Keyworker who has signed a Confidentiality Agreement as part of her service to SOLACE 

This is a self-referral form. If you know of a revert sister who is in need of support from SOLACE, please obtain her permission before completing the form on her behalf.

You can make a referral to SOLACE in two ways: 

1.    To complete the referral form, please click here and email it to This email address is being protected from spambots. You need JavaScript enabled to view it.
2.    By calling 07985641080 and a referral will be taken over the phone

If you do not hear back from SOLACE within 48 hours, please send an email to This email address is being protected from spambots. You need JavaScript enabled to view it.