Referral request

If you know of someone who may benefit from our services please fill in this form.
We aim to respond within 48 hours, thank you for your interest in our charity.

    Data protection and privacy

    I consent to Dogs for Health processing my personal data for the purpose of processing the referral and subsequent visit administration. I further consent to Dogs for Health sending me information relevant to the charity, and about the wider work of Dogs for Health.
    I understand that my contact details (only) will be passed on to a Dogs for Health Area Co-ordinator to facilitate registration and co-ordinate the referral.
    Dogs for Health takes all reasonable care to ensure the security of my data in storage and processing.
    Dogs for Health does not sell or disclose my details to any third party individual or organisation unless required to by law.