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Third Party Enquiry Form










Enquiry


(NAS is led by the person, and where possible requires their direct instruction to begin
working with them.)





Person's Details

Reason for Enquiry


(Please note NAS provides one to one representative advocacy for adults only (18+) and works on an issue specific basis. NAS do not offer long term social support or other services such as key working, social work or legal services).

Significant Others

(i.e. Friends and Family - name and contact details (Where relevant):


Other Professional Involved

(name and contact details where relevant):


Nature of Person's Disability


Primary Means of Communication


Enquirers Details


(i.e. are there specific days of the week or times of the day when it is easier to contact the person to arrange a first visit, should the advocate contact the enquirer to arrange a first visit etc.)