Staff referral information

Documents last updated: 1st April 2024

This page will be periodically updated with the correct and most recent versions of our counselling referral paperwork. Here you will find download links to our referral form and our information sheet.

Please read the below guidance before downloading our referral form. Please also note the following information is required in the form for us to process a referral:

Brief details about the loss(es), including:

– Who has died and the relationship to them (including a name, if applicable)
– When they died, and at what age or gestation
– The circumstances of the loss 

Please ensure that all clients are aware, when referred, that our counselling service operates primarily within the hours of 9am – 5pm, Monday to Friday. If they cannot make this availability work, please do not refer them to our service.

If a client requires remote counselling, please make this known on their form. Remote counselling is not offered by all of our counsellors and so the waiting time for this may be longer. Please remind the client that remote counselling operates in the same hours of 9am – 5pm, Monday to Friday.

Why is this information essential?

We have to assess as early as possible whether or not Zephyr’s service is suited to the clients needs. We must also ensure that we match them with the counsellor most appropriate to work with the clients unique experience.

Evaluating our service after the first year, there were a number of clients who were referred to us (or who self referred) who had circumstance too complex or severe for us to help with. The more information we have in advance, the easier it is for us to assess this before a counsellor is allocated.

We have also received referrals where the client did not have any daytime availability for counselling, and so we could not see them. It is important that they understand, how, when and where we operate.

There will still be an initial assessment carried out once the client is on our waiting list, but it is essential that this information is completed in the referral form in advance to speed up this process. We must ensure we are not processing referrals unless we are confident we can support them. Unsuitable referrals also add to our processing admin and waiting list, which costs Zephyr’s small team both additional time and money.

Although the form can be completed on behalf of the individual, we still require their signature to ensure they have consented to being referred to us, and understand they will be contacted by us.

Please get in touch with us at if you have any further questions or queries about the referral process.

Thank you,

Zephyr’s Team