Adult social care referral form

The Older People and Physical Disabilities (OPPD) team are the front door to Adult Social Care. We provide advice, information and a screening service to all residents over 18 years old. We then connect them to the most appropriate services.

Complete this form if you, or someone you know needs support.
You can fill this form in to refer yourself or someone you know. You can also complete this form as a referring professional.
Please ensure you have the consent of the person being referred.

We support:
• older adults (65+)
• adults with dementia
• adults (18+) with a physical disability
• carers

If you are a referring professional please fill in the information from the perspective of the person you are referring.

Please note: From 2 December 2024 there will be a separate referral form specifically for use by professionals.

Referrals can only be made via the telephone if you do not have internet access.

Most adult social care services are means tested. If you want to find out what you will have to contribute to your care, you can use our online contribution calculator

Email: OPPDContactteam@southwark.gov.uk
Telephone: 020 7525 3324.

We also provide a safeguarding service to support adults experiencing, or at risk of neglect or abuse.
In an emergency always call 999.

Information about data collected via online forms