Referral Form

Please complete the referral form below with as much accurate information as possible, this will allow us to help in the best possible way.

    To help us best assess this referral, please tell us about any support already sought or received and the outcomes of those efforts: We need to see that other relevant support options have been explored and their results documented; referrals without this information cannot be processed. We might reach out to you for additional details.

    Ineligibility Criteria for Referrals

    The following questions are designed to identify situations where The Goodwill Revolution may not be able to offer support at this time. If the answer is ‘Yes’ to any of these questions, the referral will generally be deemed ineligible and declined.

    Important Considerations for Referrers:
    • Honesty and Accuracy: It is crucial for referrers to answer these questions honestly and accurately to prevent delays or inappropriate allocation of resources.
    • Context is Key: While these are Ineligibility Criteria, TGR reserves the right to review unique circumstances. However, a ‘Yes’ answer generally indicates that TGR is not the appropriate source of support at this time.
    • Signposting: If an ineligibility criterion is met, referrers are encouraged to signpost the individual/family to appropriate specialist services that can address the specific issues identified (e.g., addiction support, legal aid, debt counselling).

    General Referral Contact

    Should you require any further clarification or wish to provide additional details regarding this referral, please email us at:

    The Goodwill Revolution: Referral Policy

    Introduction:

    The Goodwill Revolution (TGR) is committed to providing support to families and individuals in need within the Black Country. To ensure ethical and safe practices, we operate a referral system through trusted professionals. This policy outlines our referral process and the responsibilities of both referrers and TGR.

    The Goodwill Revolution focuses on providing assistance to individuals whose lives have been significantly disrupted by sudden and detrimental life events or changes in circumstances. We seek to support those who have been unexpectedly thrust into challenging situations, leading to hardship and instability. When making a referral, please clearly outline the nature of the event and its impact on the individual’s life.

    Whilst we offer a broad spectrum of assistance, each referral must specify a single, concrete request for support, including the type of support that would be most appropriate. This is a one-time opportunity, and further requests require new referrals. Support duration will be determined based on the offered assistance and may include a start and end date. Extensions may be considered upon professional advice, tailored to individual circumstances.

    Referral Sources:

    TGR accepts referrals exclusively from trusted sources, including:

    • NHS Social Prescribers
    • Schools (teachers, counsellors, SENDCo etc.)
    • Social Workers
    • Other recognised professional bodies.

    All referrals must be submitted using a verifiable work email address to confirm the referrer’s professional status.

    Confidentiality and Data Protection:

    • Referrers are responsible for maintaining the confidentiality of the individual/family they are referring.
    • Personal details of the referred individual/family will not be shared with TGR unless explicit written consent has been obtained from the individual/family.
    • TGR will liaise with the referrer to determine the most appropriate support to offer. This collaborative approach ensures that support is tailored to the specific needs of the individual/family.
    • All communication and support delivery will be managed through the referrer, ensuring compliance with GDPR, safeguarding, and ethical practices. This method protects the individual/family and reduces potential stigma.
    • It is the referrers responsibility to ensure the person/family that is being referred is aware and consents to their case being forwarded to TGR in order to request further support.

    Support Services:

    TGR provides a range of support services, including but not limited to:

    • Arrangement of counselling sessions.
    • Vouchers for shopping bills.
    • Support with the purchase of essential furniture.
    • Support with childcare costs/respite care.

    Important Note: TGR does not provide cash or money transfers. All transactions are managed via the referrer.

    Funding Availability:

    • Please note that the support offered by TGR is dependent upon the funds we have available at any given time. We reserve the right to pause referrals at any time due to lack of funds.

    Eligibility and Geographic Coverage:

    • Individuals/families referred for support must reside within the Black Country.
    • The referrer must provide the area of residence to confirm eligibility.
    • No specific personal information will be passed to TGR.

    Anonymity and Story Sharing:

    • TGR may share general stories of individuals/families who have received support.
    • No names, addresses, or other identifying information will ever be disclosed, ensuring complete anonymity.

    Referrer Responsibilities:

    • Referrers must ensure that the support requested is appropriate and necessary.
    • Referrers must confirm that the individual/family being referred has already sought support from traditional methods and/or signposted organisations (or others have sought this on their behalf).
    • Referrers must provide evidence within the Referral form that these avenues have been unsuccessful, that the full amount of support required cannot be met by other organisations, or that the beneficiary does not ‘qualify’ for support elsewhere.
    • Referrers are responsible for delivering the support to the individuals/families they refer.
    • Referrers must agree to these terms prior to making any referrals to TGR.
    • Referrers must ensure that the person/family that is being referred is aware and consents to their case being forwarded to TGR in order to request further support.

    TGR Rights:

    • TGR reserves the right to decline any referral that does not meet the criteria outlined in this policy.
    • TGR reserves the right to modify this policy as needed.

    Evidence of Support and Impact

    A condition of receiving support from The Goodwill Revolution (TGR) is that evidence of the support being received must be provided. This crucial step helps us demonstrate to our donors the tangible impact of their contributions and aids in our marketing efforts to secure further funding.

    The referrer is responsible for coordinating the submission of this evidence. This can be in one of the following forms:

    • Anonymous Video: A short, anonymous video (no identifying features of individuals or specific addresses) showing the goods in place, adaptations that have been carried out, or the general impact of the support. For example, a video of a newly furnished room or an individual engaging in an activity funded by TGR support (without revealing their identity).
    • Written Statement: A paragraph or two written by the beneficiary or the referrer, detailing the positive impact the support from The Goodwill Revolution has had on the individual’s or family’s life. This statement should clearly articulate how the support has alleviated hardship, improved circumstances, or contributed to greater stability. While specific personal details should be omitted to maintain anonymity, the narrative should be compelling and illustrative of the change brought about by TGR’s assistance.

    Please note the following important details regarding evidence submission:

    • Anonymity is paramount: No names, addresses, or other directly identifying information of the beneficiary should be included in the video or written statement.
    • Purpose of evidence: This evidence will be used in TGR’s marketing materials, reports to donors, and online platforms to showcase the effectiveness of our support and encourage continued generosity. By submitting a referral, referrers acknowledge and agree to the use of this anonymous evidence for these purposes.
    • Timely submission: Evidence must be submitted to TGR within one calendar month of the beneficiary receiving the support. This ensures we can promptly demonstrate the impact of our work to our donors and the wider community.
    • Referrer’s role: The referrer is responsible for ensuring the beneficiary understands and consents to the provision of this anonymous evidence for TGR’s marketing and donor reporting purposes.

    By submitting a referral to The Goodwill Revolution, referrers acknowledge and agree to abide by the terms and conditions outlined in this policy.

    Want to learn more before donating?

    We understand! Get all the details about The Goodwill Revolution's mission and impact.

    Subscribe for updates and see how your support can make a real difference.

    We don’t spam! Read our privacy policy for more info.