This referral form is for staff from Manchester City Council: One Manchester to refer customers for domestic abuse focused counselling. By submitting the information below, our team will be able to contact the referred customer with further information and our available appointments. 

We will acknowledge receipt of your referral within 3 working days and a member of our team will contact the service user within 5 working days.

Guidelines:

Before referring, please download our detailed guidelines to see if counselling will be suitable.

Please do not refer a customer for counselling if they are currently in crisis, as unfortunately we are unable to offer crisis support.

If you have any queries regarding whether a referral is suitable, call us on 0161 872 1100 or email us.

Email the Team

Referral Form: 

Staff Member Details:

  

Customer Details:

  

Please Note: By submitting this referral form, we will contact the customer with further information and available appointments. 

We will acknowledge your request within 3 working days and contact the customer within 5 working days.

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