Make a referral

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To make a referral to our service, please download the referral form you need below then email your completed form back to us at at yvc.uk@nhs.net. 

 

You can also contact us for advice or to discuss a referral by emailing yvc.uk@nhs.net or calling 0191 478 6472.  For more information about the different types of advocacy we provide, please visit Advocacy | yourvoicecounts (yvc.org.uk).

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Care Act Advocacy referral form (Newcastle, Gateshead and South Tyneside)

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• Care Act referral form (word doc)

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Independent Mental Capacity Act (IMCA) referral form (Newcastle, Gateshead and South Tyneside)

 

• IMCA referral form (word doc)

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Independent Mental Health Advocacy (IMHA) referral form (Newcastle, Gateshead and South Tyneside)

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• IMHA referral form (word doc)

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General non-statutory advocacy referral form (South Tyneside)

 

This service is for residents of South Tyneside only. Referrals can be made by professionals with the individual's permission or by individuals who want to refer themselves. General advocacy focuses on specific issues, and the case will be closed once the issue is resolved as much as possible.

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• General advocacy referral form (word doc)

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NHS Independent Complaints Advocacy (Newcastle, Gateshead and South Tyneside)

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• NHS ICAS referral form (word doc)

• NHS ICAS consent form  

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Rule 1.2 Representative (South Tyneside)

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• Rule 1.2 Representative referral form (word doc)

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Spot purchase requests from local authorities

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• Spot purchase referral form (word doc)

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Advocacy for people with learning disabilities

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• Easy Read referral form for people with learning disabilities (word doc)

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