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Third Party Enquiry Form


    (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.)