Village Agent Referral Form

This form can be used to refer an individual you’re working with to Cambridgeshire ACRE for support from a Village Agent. Our Village Agents work across South Cambridgeshire and Fenland. We are currently unable to support referrals for individuals living outside these areas.

We will consider referrals for (the list is not exhaustive):
  • Support to individuals that are lonely or isolated to understand and access community groups/activities in their community
  • Unpaid carers
  • Accessing health care
  • Help to complete certain forms such as Blue Badge, Attendance Allowance or Carers Allowance
  • Help to apply to the Local Authority Housing Register
  • Assistance with understanding correspondence/paperwork
  • Signposting to services that also provide help and advice
  • Support to arrange community transport for accessing health appointments
  • Support to access a foodbank or apply for foodbank vouchers
  • Help to identify benefits that the individual is not yet in receipt of but may be entitled to
  • Support to individuals that are bereaved to re-engage with others

General Data Protection Regulation (GDPR) Statement

When you commplete the form, we ask you to confirm that the individual you are referring has consented to their personal information being passed to Cambridgeshire ACRE. All information provided is treated in the strictest confidence. Cambridgeshire ACRE's Village Agent Service privacy notice setting out how we safeguard the personal data provided is available to read here.

About you


What is your name and contact details?