Adviceline 0808 278 7864 Monday to Friday 9.30am to 3.30pm

Home Visit Money Management Referral Form

This form is for HCC Adult Social Care Teams referrals ONLY

Home Visit Referral Form
Your Name
Your Name
First
Last
Please tick to indicate that the client has agreed for a referral to be made to this project; that information about their health and care needs, as well as any relevant documentation, can be shared; and the client agrees to be contacted about this referral.
Client's name
Client's name
First
Last
How do you see this referral supporting your work? (Tick all that apply)
I agree for Citizens Advice Hart to store the information I have provided in accordance with their privacy policy.

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Civic Offices
Harlington Way
Fleet
GU51 4AE

How we use your information

At Citizens Advice Hart we collect and use your personal information to help solve your problems, improve our services and tackle wider issues in society that affect people’s lives. We only ask for the information we need. We always let you decide what you’re comfortable telling us, explain why we need it and treat it as confidential.

When we record and use your personal information we:

  • only access it when we have a good reason
  • only share what is necessary and relevant
  • don’t sell it to commercial organisations

At times we might use or share your information without your permission. If we do, we’ll always make sure there’s a legal basis for it. This could include situations where we have to use or share your information:

  • to carry out our legitimate aims and goals as a charity – for example, to create statistics for our national research. This is called ‘legitimate interests’
  • to comply with the law – for example, if a court orders us to share information. This is called ‘legal obligation’
  • to protect someone’s life – for example, sharing information with a paramedic if a client was unwell at our office. This is called ‘vital interests’
  • for us to carry out a task where we’re meeting the aims of a public body in the public interest – for example, delivering a government or local authority service. This is called ‘public task’
  • to carry out a contract we have with you – for example, if you’re an employee we might need to store your bank details so we can pay you. This is called ‘contract’
  • to defend our legal rights – for example, sharing information with our legal advisors if there was a complaint that we gave the wrong advice.

We handle and store your personal information in line with the law – including the General Data Protection Regulation and in line with our Citizens Advice policy.

Please note that by completing your phone number and/ or email address in the form above you are giving permission for us to contact you using the details shown.