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Advocacy Referral Form

Please read these notes before completing this form:

You are encouraged to prepare some of your answers beforehand in a document and paste the text into the relevant boxes. If your internet connection is lost while completing the form, unfortunately you will have to start again.

Fields marked with a red asterisk * are always required. Any you omit will be outlined in red after you click the “Submit” button. After completing those fields, please click Submit again.

For professionals: referral for support outside our normal contracts will be chargeable via Spot Purchase and will not be allocated until the purchase is authorised. Please use one of the referral forms below and we will contact you for purchase authorisation. Follow these links if you require more information about Spot Purchases , 1.2 Representative , Litigation Friend or  Relevant Person's Representative.

Referral Form

Click to start an Online Referral in English

The online application form will be uploaded to
a secure server accessible by Dewis CIL.

Click to start an Online Referral in Welsh

The online application form will be uploaded to
a secure server accessible by Dewis CIL.

Easy Read Referral Form

Click to start an Easy Read Referral in English

Use this if you want to make a self referral but find it hard to fill in forms.

Or you can download a referral form as a Word document

If you would prefer to download the form as a Microsoft Word document, please use one of the links below:

Advocacy Referral Form in English

Advocacy Referral Form in Welsh

Easy Read Advocacy Referral Form in English

These forms are less secure than our online form. These should be password protected before emailing to us and the password sent in a separate email.

Please note: only the current version of these forms will be accepted. If an old version of a form is received we will ask that the current form be completed instead.

Published: 14th August, 2019

Updated: 23rd May, 2025

Author: Dave Hall

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Dewis CIL is a company limited by guarantee registered in England and Wales under number 3179464 and registered as a Charity number 1098229.
Registered office: Suite 4 and 5, Nos 1 & 2 Melin Corrwg, Upper Boat, Pontypridd, CF37 5BE. © Copyright 2019 Charity. All rights reserved.

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