The following webform is for the referral of patients from Lewisham University Hospital to Community Connections Lewisham.

Before completing the form below please make sure you check our eligibility criteria below to ensure we are the appropriate service for your patient. You can also find out more about whether we are the right service for your patient here.

Patient Eligibility Criteria:

  • The person you are referring is aged 18 or over and lives in the borough of Lewisham
  • You have no concerns about the patient’s mental capacity
  • The patient is not currently engaging in regular alcohol or substance misuse



Please fill in the following details about yourself so that we can send you feedback on your patient.


Please complete all of the details below in order that we can create a client account for this patient within our service
Please complete as DD/MM/YYYY
We collect this information to determine whether we are reaching all of the types of people who live in Lewisham, or only some of them. We need to make sure our service is accessible to every isolated adult who needs it. These questions can be uncomfortable, so you can choose ‘prefer not to say’ for any.
Please let us know the current location of your patient, such as 'at home' or the name of their hospital ward
A carer is anyone who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid and covers things like cooking meals, washing, helping with personal hygiene, etc.


With their consent we can contact a relative or friend of the patient being referred. If relevant, please enter their details below:


Please answer the following question to let us know why you are referring this patient to Community Connections Lewisham.
Tick any that apply
Tick any that apply
Please provide any further information you think we should be aware of, such as any relevant medical conditions or if they are being supported by another organisation(s)


In accordance with DPA 1998 and GDPR you have rights regarding your data, including requesting that we remove your data from our system at any point. For more information please contact AUKLS by emailing or by phoning Community Connections Lewisham on 0330 0583 464.

What happens next?

Once your completed referral is received one of our team will get in touch with the patient (or their NOK if requested) to discuss their support needs further. Please note that CCL is not an emergency service and should not be contacted for urgent issues or confused with Adult Social Care. Due to high demand patients can expect to wait a few weeks before receiving contact from our team.