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24 hour advice phone line:
0191 529 7108
(for patients and healthcare professionals only)

Respite Care referral

If you need any help using our online referral system, please call the Referrals Team on
0191 529 7100

This page is for healthcare professionals to make patient referrals. The quickest and easiest way to make a referral is to use our online referral forms. However, if you would prefer to print off a form and send it to us by post or fax, you can download them using the links on each service listing below.

Online referral form

Patient Details

Next of Kin



Is the patient aware of the diagnosis?* (please click)

Yes No

Is the family aware of the diagnosis?* (please click)

Yes No
You agree that all information provided is correct to your best knowledge*