Little girl sat on a bench in the hospice garden.

Make a referral

If you'd like to refer a child or family to us, even in pregnancy, we make the process as fast and simple as possible:

call us on 01484 411042
email us at care@forgetmenotchild.co.uk
download a referral form and send it back to us
...or simply fill out the form below and we will be in touch within 24 hours.

Why not make your life easier, and a family's life better?

First Name *

Last Name *

Job Title *

Organisation *

Email *

Home phone *

Mobile *

Which area or areas do you require assistance with?

Family Support
Paediatric
Perinatal

Best way for us to contact you *

Phone
Email
Text

Best time for us to contact you *

Morning
Afternoon
Evening

Forget Me Not Children’s Hospice will use this information so that we can make initial contact with you. For further details on how we use your information, including how long we will keep it for, please click here to view our Privacy Policy. You can ask us to stop processing your information at any time by contacting us using the details in the Privacy Policy.