Make a referral

Make a Referral

Use the form below for organisational referrals (councils, housing associations, NHS) and family referrals.

Make a referral

Use the form below for organisational referrals (councils, housing associations, NHS) and family referrals.

Private Client Service (enhanced discretion)

Designed for clients who require the highest level of discretion and privacy. Director-led support under a mutual NDA, with unmarked vehicles and discreet invoicing. This is a separate premium service arranged directly with Neil.

Visit Private Client Service neil.mitchell@hoardinghelpers.co.uk

If you are concerned about a loved one and there is a risk to their health or safety, please call 111 or 999, or encourage them to see their GP.

For non-emergency guidance, Hoarding UK is a leading charity that can offer advice.

Your referral is protected by two-factor authentication. Only authorised Hoarding Helpers staff can access the information you submit.

Please share only what is necessary. You do not need to include full medical history — a brief summary of relevant health or support needs is sufficient.

Section 1 — Referrer details

Your full name

Work email address *

Work phone number

Extension (optional)

Organisation / team

Job title / role

Preferred contact method

How did you hear about us?

Date of referral

Section 2 — Client details

Client initials

Your client / case reference

Client first name

Client last name (optional)

Date of birth

Client phone number (optional)

Client email address (optional)

Interpreter / language support needed?

Client address

Postcode

Living situation

Tenure type

Property type

Lift available?

Floor level / stairs

Parking / vehicle access

Mobility / access needs (optional)

Key holder / access arrangements (optional)

Access notes

Section 3 — Referral details

Services requested (select all that apply)

Urgency / priority

Client availability / preferred appointment times (optional)

Client consent & awareness

Section 3b — Room clutter assessment

Scale guide Photographs (PDF)

Rate each applicable room using the Clutter Image Rating (CIR) scale: 1 = minimal clutter, 9 = severe. Leave blank if the room was not accessed or does not apply. View scale guide · Photographs (PDF)

Bedrooms

Bedroom 1

Bedroom 2

Bedroom 3

Bedroom 4

Kitchen & dining

Kitchen

Dining room

Utility room

Living areas

Living room

Lounge / sitting room

Conservatory / sunroom

Bathrooms & WC

Bathroom

En suite

Separate WC

Circulation & storage

Hallway / entrance

Landing / stairs

Loft / attic

Cellar / basement

Cupboard / storage room

Outside

Garden / outdoor space

Garage

Outbuilding / shed

Other

Other room / area

Room assessment notes

Section 4 — Risk & health information

Fire risk identified?

Safeguarding concern?

Known mental health diagnosis?

Known neurodivergent diagnosis?

Pets present?

Previous allegations or complaints against professionals?

Sharps / needles risk?

Aggression / behaviour risk?

Vermin / infestation present?

Self-neglect concerns?

Substance misuse?

Biohazard / bodily fluids present?

If safeguarding concern — please provide brief details

Section 5 — Background information

Previous or current support in place

Safeguarding concerns — further detail

Additional information / reason for referral

Supporting photos

Optional — attach up to 5 photos (clutter level, access, property condition). JPG, PNG or HEIC, max 10 MB each. You can select multiple at once or click again to add more.

Choose photos…

Declaration

I confirm that I am a professional referrer acting in an official capacity, that the information provided is accurate to the best of my knowledge, and that I have the authority to share this information with Hoarding Helpers in accordance with my organisation's data sharing policy. I understand that this referral will be handled in confidence and in line with GDPR. Where applicable, the client has been informed that this referral is being made and has given their consent for their information to be shared with Hoarding Helpers.

Download blank referral form:Printable form (HTML)For referrers who prefer to complete and email the form offline.