You can refer yourself for Community Connections Lewisham support using the form below. The wait time is currently six weeks, so if you need support more quickly please call us or visit our weekly Drop In session. 

Community Connections Lewisham is not an emergency service so should not be contacted for urgent issues. If you’re worried about someone’s safety or welfare, contact Lewisham Adult Social Care on 0208 314 7777 or email them at Gateway@lewisham.gov.uk. In an emergency, always dial 999. 

If you require a benefits check only, we recommend contacting Advice Lewisham directly on 0800 231 5453, which is open Monday-Friday, 9.30am-12.30pm and 1.30pm-4pm. 

Please note: the form below will not work correctly using Internet Explorer. Please complete the form using a different browser like Google Chrome or Firefox. Using an Ad Blocker can also cause problems, please turn it off if using this form as using one may result in your referral not being received.  

CCL Referral Form

SECTION 1 - REFERRER DETAILS

Please complete this section if you are making a referral on behalf of another person.
Please select the appropriate category/organisation name. If none apply then please select 'Other'.

SECTION 2 - DETAILS OF THE PERSON SEEKING SUPPORT

Please fill in as DD/MM/YYYY
*Please Note- if you are referring yourself and would like to receive an email confirmation of this referral then please enter your email address in Section 1 above in the box entitled 'Referrer Email Address'.
If you do not have this information please select ' Unknown'.

SECTION 3 - WHAT TYPES OF SUPPORT ARE NEEDED?

Please tick any relevant boxes from the checklist below.
Please summarise briefly the reason for this referral and if there is any additional information you think we should be aware of. Please include information on any relevant medical conditions and if you are currently receiving support from any other professional organisations.
In order to help you, we need to store information about you. The law says that we must get your consent to do this. Everything you tell us will be treated confidentially and your data will be subject to the Data Protection Act 2018. Records will be kept securely for 6 years and then securely destroyed. For more information please visit our website at http://www.communityconnectionslewisham.org