Referrals

We’re here to support people in Hertfordshire living with sight loss.

Use this page to make a referral to Herts Vision Loss so our team can understand the person’s needs and help connect them with the right support, advice, and services.

Please complete the form below and press submit.

Please answer ALL questions as fully as possible; do not leave any blanks or use acronyms. Any incomplete referrals will need to be returned to the referrer to be completed before we are able to process it.

  • You can follow up this referral by contacting HVL via Tel: 01707 324 680 or email office@hertsvisionloss.org.uk
  • Important note: If you call in to make a referral by telephone, please note that we will require all the information requested on this referral before your referral can be processed.

Please enter personal details and select relevant support services. If referring for someone else, enter their details and note your relationship in the further information section.

Thank you

Self-Referral Form

Download the Professional Referral Form

Download Word DocDownload PDF