Make a referral

If you support someone with inherited sight loss and they need additional support or information, you can make a referral to one or more of our dedicated services.

Our support is free and accessible.

The services we offer include:

Information and support from our Helpline team either on the telephone or via email
Being paired with a somebody on our Talk and Support service
Access to our growing Local Peer Support groups and speciality interest groups
An assisted journey through our Discover Wellbeing programme
Speak to somebody with lived experience of Charles Bonnet Syndrome (CBS)

More information about the information and support services we are offer can be found on the services page.

Make a referral

About you

Name(Required)

Prefix First Last

Organisation name(Required)

Phone

Email(Required)

About the person you are referring

The reason for referral to Retina UK (please detail support required if known)(Required)

What is your relationship to the person you are referring?(Required)

Full name of the person you are referring(Required)

Prefix First Last

Email(Required)

Phone(Required)

Their communication needs

Please indicate how the individual should be contacted about the referral

Phone (voice call)

Text message

Your privacy is our priority. We promise to keep your details safe and will never sell them. Just for your information we use an email broadcast company based in the USA. Would you like to know more? our privacy policy explains all: RetinaUK.org.uk/privacy-policy.

If you would like to change the way you hear from us, how we use your information or do not want to receive and further communications from us, just email info@RetinaUK.org.uk, call 01280 821334 or write to us at Retina UK, Whiteleaf Business Centre, 11 Little Balmer, Buckingham MK18 1TF.

Name

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