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Referral submitted.
We've received it and will be in touch within 2–3 working days. A confirmation has been sent to your email.
Your reference number
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What happens next
Within 2–3 working days — a member of our team will review your referral and assess programme suitability.
Initial contact — we'll reach out to the young person (and yourself if needed) to arrange an introductory meeting.
Programme matching — we'll confirm which of our sessions would be the best fit and share dates/times.
Questions? Email us at info@urbanheard.org.uk quoting your reference number.
About you
Your details as the referring professional. All fields marked * are required.
Organisation / Agency *
Are you this young person's key worker?
Please select…
Yes, I am their key worker
No, I am referring on their behalf
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About the young person
We only need a first name at this stage to protect their privacy (GDPR). We'll collect full details once they're engaged with us.
Area / neighbourhood *
Select area…
Chelmsley Wood
Smith's Wood
Castle Bromwich
Kingshurst
Fordbridge
Marston Green
Solihull Town Centre
Shirley
Olton
Knowle & Dorridge
Dickens Heath
Hampton in Arden
Meriden
Balsall Common
Outside Solihull
Gender identity (optional)
Prefer not to say / unknown
Male
Female
Non-binary
Other / self-describe
School or college (optional)
Does the young person know about this referral? *
Please select…
Yes – they have agreed to the referral
They know a referral is being made but haven't seen the details
No – this is being made without their prior knowledge
Parental / guardian consent *
Please select…
Yes – consent obtained
Not applicable – young person is 16 or over
No – not yet obtained (please explain in notes)
Unable to obtain – circumstances noted
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Referral details
Help us understand the context so we can match this young person to the right programme and prioritise appropriately.
Why are you referring this young person? *
How urgent is this referral? *
Anything else we should know? (optional)
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