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New Ethos Nottingham Referral Form

Please download our criteria 

We have a downloadable version of our referral form for your convenience.

All referrals for New Ethos Nottingham 2 CIC, even if the service user has been signposted from another service are classed as self-referrals. This means we need to speak to the service user directly. All service users must have a local connection.


Once telephone contact has been made and basic details and requirements have been established, we would arrange for the service user to visit New Ethos House for an assessment. This can last between 1 and 2 hours.

The assessment will focus on the service user's motivation, levels of honesty/awareness, and readiness/suitability for entry into the project.  Both staff and resident coordinators are trained to undertake the assessment process, however, any confidential issues and risk assessments will only be discussed with staff members. This would also give the service user the opportunity to assess the suitability of ourselves for their needs.

If successful, and all eligibility criteria have been met, the service user will either be placed on the waiting list and be invited to attend a pre-admission group or may even be given an admission date there and then.

For further information or to declare an interest in making a referral, please complete the form below and we will get back to you as soon as possible.

Alternatively, you can contact us direct on:


Referral form


How we communicate with you.

Do you need an interpreter?

We will usually write to you, but we may sometimes need to interview you at our Head Office.

If we ask you to come for an interview, will you need someone to translate for you?

If you have answered 'Yes', what language do you speak?

How would you prefer us to communicate with you?

If you have answered 'Letter', do you need any letters translating into another language?

What language do you need the letter to be in?

Do you have any other special requirements?

(Such as large print)

If you have answered yes, what are they?

How to apply

Please fill in this application form

You must answer all the questions that apply to you. If you do not answer all the questions fully, we will return this form to you.

Make sure you return all the information we ask for. See section K for a checklist of the information that you should send us.

Continue to Application
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