Bramber Bakehouse

Befriending service self-referral

"Befriending offers a supportive, reliable relationship to people who would otherwise be socially isolated"

Befriending Networks

Please read the Bramber Bakehouse Befriending Leaflet before completing this form as it provides key information about the service.

Please complete all sections of this form, providing as much detail as possible will support the Coordinator to:

1) Assess whether the befriending service is appropriate for your current needs
2) Match you with a suitable befriending volunteer

If have any questions about this form please get in touch:
Dionne Widgerey, Progression Programmes Lead, 07946 334180 or email befriending@bramberbakehouse.co.uk

Please confirm you are:(Required)
Address

Bramber Bakhouse’s befriending service offers an informal social relationship which can help to reduce isolation through the creation of meaningful connection.

At Bramber Bakehouse we define ‘socially isolated” as needing more meaningful connections with others (i.e. positive relationships including with friends, neighbours, wider community) and needing more social support or contact (includes in-person/ telephone/ online contact).

To help us understand your needs from our befriending service and ensure we create a suitable match for you, it is helpful for us to understand the levels of social isolation you are facing.

Please select the option below that best describes your environment:(Required)
Please select the option below that best describes your environment:(Required)

Please rate the following statements based on your current situation

I feel listened to(Required)
I feel safe(Required)
I feel socially connected(Required)
I have good health & wellbeing(Required)
I have good self-esteem (e.g. I like & believe in myself)(Required)
I am aware of opportunities in the community(Required)
I feel confident to access opportunities in the community(Required)
I feel hopeful for my future(Required)

About your availability & preferences for befriending:

Befriending takes place for up to 16 sessions. Calls take place between Monday - Thursday 9am to 5pm lasting up to 30 minutes per session. Where possible befriending calls will take place at the same day and time each week.

What is your preferred format for befriending calls:(Required)

When would be the best time for your befriending calls:

Please select all the times that you could make.

Monday
Tuesday
Wednesday
Thursday

How will you use my data

I consent to the information contained in this self-referral form being shared within Bramber Bakehouse and, if necessary, with relevant parties working in partnership with Bramber Bakehouse.
MM slash DD slash YYYY