Energy Referral Form (Trusted Partners)

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You have been given access to this referral route as a trusted partner of Citizens Advice South Hams and Citizens Advice Teignbridge. In order to make a referral for your client please provide their details below and one of our team will aim to contact them directly in the next 5 working days. DO NOT share this page with your client and do not include any Special Category Data (e.g. details of any medical conditions). Thank you.

Email *

I confirm the client lives in South Hams or Teignbridge. *

Yes

As the referring professional, I can confirm we have the client's consent to pass on their details to Citizens Advice South Hams. *

Yes

Client's full name *

Client's date of birth *

YYYY

Client's address including house name/no and postcode *

We aim to contact your client within five working days. We will make a minimum of three attempts to contact the client and if we are unable to do so they will be removed from our waiting list.

I confirm the client has consented to be contacted by Citizens Advice for the purpose of this referral and the client has been advised that phone calls will appear as PRIVATE NUMBER or NUMBER WITHELD.

Yes

Please indicate which of the following contact methods the client is happy to be used by Citizens Advice to contact them (in addition to a phone call).

SMS

Voicemail

Post (this will only be used if none of the other options are ticked and it is not possible to speak to the client when they are phoned)

Client's email address?

Client's main telephone number *

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