Do you know someone who needs help?

Not everyone feels comfortable asking for help, so if you know someone that needs help, but is reluctant to ask, fill out our referral form.

You could be saving their life.

1. Before you begin

Please complete this referral with the service user. Fields marked as required must be completed. For other fields, enter “None”, “Not applicable” or “Not known” where appropriate. This form does not save progress; please have the relevant information ready before starting.

Who the service is for

Recovery First Housing primarily provides supported accommodation for people in recovery from substance misuse. Applications are considered for people who:

  • Have completed a detox and rehabilitation programme or have been abstinent for 28 days, and are committed to their recovery.
  • Are homeless.
  • Have a local connection, or can create an emergency discharge plan with staff and family.
  • Have substance misuse as their primary issue.
  • Are willing to engage with appropriate care plans and support.
  • Have low to medium support needs.
  • Are aged 18 or over.

There is no overall exclusion policy. However, a referral may be declined if there are no housing needs, support needs or risks cannot be managed by the service, the applicant refuses to sign relevant forms, or information is knowingly withheld or falsely provided. Other reasons may apply and will be explained. Information about other options and the appeals process will be provided.

Applicants need to demonstrate willingness, open-mindedness and honesty. A risk assessment and management plan will consider the safety of the applicant, staff and community. Where risk is too high, the applicant will be referred to another service.

2. Service user details

Enter the applicant’s personal and next of kin details.

Next of kin

3. Referring agency

Tell us who is making the referral and how we can contact them.

If this is a self-referral, enter “Self-referral” for the agency and use your own contact details.

4. Background and recovery

Provide the background information relevant to this application.

Identification the service user can provide

5. Employment and income

Select all applicable sources and provide the payment details below.

Employment and income sources

6. Support needs

Indicate the areas where support is needed.

Core support areas: drugs and alcohol misuse, and managing accommodation or tenancy. These are mandatory support areas in the original referral form.

Additional support needed

7. Health and medication

Provide relevant mental health, medication and physical disability information.

Mental health needs that apply

8. Substance misuse

Select all applicable issues and provide details for each one.

Substance misuse issues that apply

9. Professional involvement

List other professionals or agencies involved in the service user’s care.

You can include additional professionals in the last box.

10. Accommodation history

Cover the last five years, starting with the most recent address. For each address, record any problems in the categories listed below.

11. Criminal history

For each category, indicate whether there is a conviction and give the outcome or sentence. Select “Not known” where appropriate.

12. Orders and supervision

Record whether the service user is currently, or has previously been, subject to any of these arrangements.

13. Emergency discharge plan

Provide the proposed arrangements for a safe discharge.

An emergency discharge plan is a condition of being offered accommodation. If discharge is necessary because of relapse, unacceptable behaviour or a breach of agreed conditions, the service needs to know there is somewhere safe for the service user to return to. This may be a nominated friend or family member. If they cannot offer accommodation at the time, the service user may need to return to their local authority for emergency housing.

14. Consent and declaration

Please record the service user’s choices and declaration.

This section must be completed by the service user. Please review the information above before confirming the statements below.

Consent to submit personal details *
Permission to update the referring organisation
Consent to contact and assessment *

Your personal details will be kept confidential and will not be shared with anyone else without your consent, unless Recovery First Housing is legally obliged to do so. Further information about how your personal information is used and stored is available in Recovery First Housing’s data protection policy and privacy notice.

Service user declaration *

Our past residents

See what some of our previous residents had to say about our team and the services we provided.

It’s been an incredible experience for me here. From day one, when I was a fearful, timid man, to now, where I have been learning how to alter my life, I have come a long way. I’ve grown as a person as a result of my work with Recovery First Housing. I’m confident in myself and I’m the happiest I’ve been in a long time.

Jonathan, Our past resident

Without a doubt, the most crucial two years of my life has been so much easier with the help of Recovery First Housing CIC. The practitioners and support staff have all been outstanding. I had no idea empathy and understanding could be at such a high level, especially from strangers. They’ve gone from being my guides, to my friends.

Marcus, Our past resident

I went in with no idea what to anticipate, no idea who I’d be with, and no idea where I’d be heading. What I discovered was a network of people who shared the same condition as me – addiction. We learned together, became friends together, and discovered ourselves during our time together, all the while being helped by Recovery First Housing CIC and their programme.

Amy, Our past resident

Contacting Recovery First Housing CIC may have saved both my life and my marriage. I’ll be eternally grateful for the tools and knowledge they’ve given me to help me get on top of my addictions.

Ian, Our past resident


There’s nothing wrong with
reaching out for help

“All we need is somewhere to live, something to do and someone to love”