Please enable JavaScript in your browser to complete this form.Name of Surgery or Health Related EstablishmentAddressPostcodePractice Telephone NumberName of the person completing this form *FirstLastEmail Address of the person completing this form *CCG or Health Board1 - Were you aware of the local authorities duty and how to refer?YesNoA person may be considered homeless if they are street homeless (rough sleeping), sofa surfing, staying at a hostel, a B&B (not on holiday) or in temporary accommodation. If a person informs you they are homeless or threatened with homelessness, The Council (local authority) have a duty to offer assistance as directed within the Homeless Reduction Act. You can refer the person via The Duty To Refer (Homeless Reduction Act), how to refer can be found on the Council's Website within their homeless/housing section and is usually an online form. 2 - Are you aware you can register a person who is homeless if they are unable to give you an address?YesNoWhen supporting a person who is homeless please ensure that you ask the person how they would like you to contact them such as phone, text, email or c/o address (this could be a day service support or a friend’s address). Many people who are homeless experience difficulty completing forms, this could be due to English being a second language, difficulty reading and writing or simply not having reading glasses. Please offer to assist a person to complete necessary paperwork. You can use your organisation as a c/o address but be aware that when doing this you need to ensure that you have a way of contacting the person (such as an informal contract stating that they will call in once a week) 3 - Can your organisation offer support to complete forms?YesNo4 - Are you able to be flexible should a person ask for your assistance?YesNoExpecting people to telephone or attend the surgery at a certain time to make an appointment may be extremely difficult for a person who is homeless. A person that is homeless may have experienced traumas which could in trust issues. A person may contact you as a last resort, by being flexible and understanding you are starting small steps in building up a relationship of trust. 5 - Do your procedures etc enable fair access to prevent discrimination?YesNoWe ask organisations to examine their policies and procedures to ensure that they do not prevent people who are homeless from accessing a respectful and inclusive service. 6 - If you are outside Greater Manchester please state below and we will send you details of your local rough sleeper service. If you are concerned about someone sleeping rough, please talk with them, offering to refer them for support, all councils either have their own rough sleeper support staff or link into street link. The contact number for StreetLink is 0300 500 0914. https://www.streetlink.org.uk/an You can find details of all the Greater Manchester contact numbers on our ‘Contact Us Web Page’ 7 - Name of contact person and email or telephone number?FirstLastWe list Homeless Friendly GP Practices and other relevant organisations on our website, we ask for a named person as the contact person. This enables support organisations to know who to contact should there be a problem. Having a named person or a champion as they are often described encourages the named person to develop an expertise in relation to local support services. Phone NumberEmail *8 - Are you interested in finding out further information? (no commitment) YesNoWe are able to supply further information on local support services and also offer bespoke training. Please state as to what you’re interested in?9 - Have you or your organisation experience of supporting a person or people who are homeless? If so please tell us further information relating to this support.10 - If you have any queries or a questions for us at Homeless Friendly please feel free to ask them below:Finally Homeless Friendly offer ongoing support to all Homeless Friendly Practices in the form of assistance with queries, problem solving and guidance should you need it. If you are pledging that you personally or your organisation wants to be acknowledged as being Homeless Friendly please submit your answers and someone will contact you shortly forwarding on your pledge as appropriate.Personal pledgeorganisation pledgePledge