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Referral from a friend or family member

Please use this form if you are contacting us on behalf of a friend or family member. Please make sure you get their consent first.

How did you hear about KAB? (choose an option below)

About you

Your First Name

Your Surname

Your Telephone/Mobile number

Your Email

Your relationship to the person you are referring

Has the person you are referring consented to this referral?

Yes

About the person you are referring

Their Title

Their First Name

Their Surname

Their First line of address

Their Town

Their Postcode

Their Email

Their Telephone/Mobile number

Is there a best time/day to contact them on?

Do they have any special contact requirements?

Reason for the referral

KAB collects and securely processes the personal information provided on this form in order to process your referral, which may involve sharing with Social Care Services. KAB respects your privacy and will ensure personal information is collected fairly, lawfully and in compliance with the UK General Data Protection Regulation. If you wish to know more (including about how long your data will be stored) or have any concerns about how your information is used please contact KAB at enquiry@kab.org.uk. If you need to speak to KAB about your referral, please call us on 01622 691357 and press 1 to speak to our Rehabilitation department. We endeavour to make contact within five working days of receiving this form.

Some of the ways we help people

Rehabilitation

Our specially trained Rehabilitation Workers give you help and advice through an assessment at your home or workplace.

1-2-1 Support

Through our Guide Communicator service, we can provide extra support to help you manage everyday tasks and activities.

Technology skills

Our free Assistive Technology service will teach you how to access information and communicate using computers and other technology regardless of your level of sight, age or ability.

Counselling

KAB’s free Counselling service, delivered by our highly trained team, can help with issues that may be affecting your life, in addition to sight loss.

ECLOs

Our Eye Clinic Liaison Officers (ECLOs) support people attending eye clinic outpatient appointments across 10 hospitals in Kent, Medway, Bromley and Bexley.

Young people

Our caring team are dedicated to helping children and young people with a sight impairment to become as independent as possible. This includes mobility skills (using a cane), support within their school environment and activities such as theatre trips and ice-skating.

Iris – Mobile Sight Centre

If you would prefer to chat to any member of our team, you can visit us aboard Iris, our Mobile Sight Centre. Find out where we’ll be visiting, by viewing our Iris events page.