Apply for Help

  • Use the form below to apply for individual help and advice for yourself or someone else in Somerset, Mid Devon, West Devon, North Devon or Torridge. If you are struggling or would prefer to apply for help over the phone, please contact us on 01823 299050.
  • Please note: Any information filled out in the form will not be saved until the form is submitted.
  • There are also other ways to get help and advice from us in Somerset or Devon. Find more information and join a free group workshop here.
  • If you are looking for education and training services for students or employees for an organisation anywhere in the UK please contact us for details of what we can provide.

Ask for Help from Navigate …

If you need help with completing the form, please contact us.

    1

    Can We Help?

    2

    Previous Help

    3

    Client Personal Details

    4

    Client Contact Details

    5

    Client Home Situation

    6

    Client Past and Current Help

    Find Out if You Can Apply

    Who would you like help for?

    Do you live in Somerset, North Devon, Mid Devon, West Devon or Torridge?

    Does the person requiring help live in Somerset, North Devon, Mid Devon, West Devon or Torridge?

    Please select any of the following which make it difficult for you to access advice and support. Please select all that apply.

    Please select any of the following which make it difficult for the person requiring help to access advice and support. Please select all that apply.

    We are sorry but we can provide free advice and support for individuals only in the above council areas with qualifying needs.

    There are other organisations that can provide support anywhere in the UK.

    Who should we contact to discuss this referral further:

    We want to make sure that we understand the client's needs. To help us do this, our triage team will contact you as the referrer. It may be difficult to proceed with your referral until we have the necessary information to provide your client with the help that they need.

    Before you tell us about the person requiring help, please tell us a little more about yourself:

    We will store your contact details for our records. This is kept for 12 years from the date money and/or debt advice is concluded or 2 years if it does not proceed.

    Please indicate that the person requiring help consents to you sharing their information with Wis£rmoney to access the services we provide and that you, as the referring party, have explained to them and they agree to and understand the following information:

    • That personal and sensitive information may be provided by you about them in order to make a formal referral into the Wis£rmoney service
    • That personal and sensitive data will be shared on a need to know basis in order to make an appropriate referral.
    • That personal information may be kept in a file or on computer. If money and/or debt advice doesn’t proceed, personal data will be destroyed after 2 years. If money and/or debt advice does proceed, a Wis£rmoney member of staff will provide the client with a copy of our Privacy Notice explaining in more detail what will happen to their data
    • You can find a copy of our privacy notice here

    Please indicate that you consent to us storing your details for the purposes of processing your referral. Personal information may be kept in a file or on computer. If money and/or debt advice doesn’t proceed, personal data will be destroyed after 2 years. If money and/or debt advice does proceed, a Wis£rmoney member of staff will provide you with a copy of our Privacy Notice explaining in more detail what will happen to your data.

    Help required. Please tick all that apply.

    Reason for Referral

    Please provide as much additional information as possible.

    Risk Assessment:

    The safety of our staff and clients is our greatest concern. We may contact you specifically to clarify details related to any risk present.

    Since we work with our clients in their home, usually on a 1-2-1 basis, are there any risks present in visiting this home? Examples include: Access to property, Substance misuse, Criminal history, Behavioural concerns, Pets etc.

    Please Tell Us About Any Help Already Sought

    Have you sought help with money, debt or benefits from another organisation?

    Has the person who requires help sought help with money, debt or benefits from another organisation?

    How did you hear about us?

    Please Tell Us About You

    Please provide as much information as you can.

    Please Tell Us About the Person Who Requires Help

    Please complete the following sections on behalf of the person seeking help, providing as much information as you can.

    Name

    Gender

    Gender Reassignment

    Personal Pronouns

    Date of Birth

    Marital Status

    Ethnicity

    Nationality

    UK Immigration Status

    Address

    Please Provide Us With Contact Details

    Can we leave a message at home?

    Can we leave a message on the mobile?

    Preferred Method of Contact

    Please Tell Us About Your Current Situation

    Please Tell Us About the Current Situation of the Person Requiring Help

    Housing Situation

    Number of Adults in the Household

    Number of Children in the Household

    Best description of personal situation:

    Please Tell a Little More About Past and Current Help

    Have you sought advice from us before?

    Has the person requiring help sought advice from us before?

    If you are currently working with any other service(s), please tell us who:

    If the person requiring help is currently working with any other service (s), please tell us who: