Refer someone else

Your details

Name*

Phone*

Email

Their details

Please make sure this person is aware you are making a referral as we can only help someone who agrees to our support.

Name*

First Last

Phone*

Email

Relationship to me*

Additional information

Anything you would like to tell us

Please tick to confirm that:*

You have discussed with the person you are referring
The person you are referring is aware that Jami is a mental health charity
The person you are referring is aware that you are giving Jami their name and contact number

How did you hear about us?

Other

Consent

I give my consent

By filling in this form I confirm that I am consenting to Jami holding and processing my personal data to keep me informed about Jami’s services, courses, events and fundraising. Where you do not grant consent we will not be able to use your personal data; (so, for example, we may not be able to let you know about forthcoming services and events); except in certain limited situations, such as where required to do so by law or to protect members of the public from serious harm. You can find out more about how we use your data and how to withdraw your consent from our Privacy policy.