Rough sleeper referral form

If you are concerned about someone you've seen sleeping or living rough in the St Albans area, please contact our street outreach service so that we can make contact with them.

You can call us on 01727 859113, send an email or complete as much detail as possible on the form below. Please provide as much information as possible about the person and when and where you have seen them to help us make contact with them.

How can we identify this person?

Please describe the person sleeping rough to help us to identify them.

1. Gender Please select Male Female Unknown
2. Skin colour
3. Describe any facial hair
4. Estimated age Please select Under 18 19 - 25 26 - 39 40 - 55 Over 55
5. Rough height
6. Describe any other distinguishing features including clothing

Sleeping site

Clearly describe where this person usually sleeps

1. Street name
2. Town/city
3. Clearly describe where the sleeping site is (eg in the car park by the ticket machine)
4. How long have they slept here?
5. When are they usually at this site?

Referrals from supporting organisations

If you work for a supporting agency please complete any further details about the rough sleeper that may be useful

1. Name of person
2. Do they know about this referral? Unknown Yes No
3. Do they have any support needs (eg alcohol, drugs, mental health, physically vulnerable etc)?
4. Do they have a history of violence or anti-social behaviour?
5. Referrer's contact details
6. Referrer's name
7. Referrer's organisation