Referral Forms

Please download, complete and submit a referral form should you wish to refer a service user to our service. Once you have completed the form, please send to

Please take note of our eligibility and suitability criteria below, and please ensure you fully complete the form before submitting as incomplete referrals will be returned. 

All referrals submitted get a reply confirming receipt. If you do not get this, please call us to ensure we have received your email. 

If you require a CJSM email please send your referral to

If you use other secure email platforms, we may have difficulty receiving your email. We do have an egress email should you wish to send your referral via egress. Please call us for this email address.

PLEASE NOTE: The Young Person's County Pilot for APV and IPV ands Adult Perpetrators ended in September 2018, and we no longer accept referrals for young people or adult perpetrators from the County. However, Local Authorities are able to Spot Purchase individual places on our programmes. 

Please contact The Service Manager for more information.

Our City APV and Perpetrator services are unaffected and are running as normal. 

Please print a copy of our leaflet to give to the service user you have referred by clicking the link at the bottom of the page. 

Making a Referral



The client/s cannot be involved in ongoing criminal legal proceedings relating to their use of violence/abuse.

Where clients are in public and private legal proceedings relating to child safeguarding they are also ineligible for the service until the proceedings have ended. If the client is in pre-proceedings or is likely to be entering proceedings,  relating to safeguarding children, contact the Jenkins Centre to discuss before referring. 

Perpetrators who are have completed another perpetrator programme (e.g. IDAP) within the last 6 months are ineligible 


Consider the following when making a referral:

Does the perpetrator admit to having used at least some violent/abusive behaviour?

Do they demonstrate some motivation to change it?

Are they likely to be able to reliably attend assessments/ a programme?

Are there any other barriers to participation that need to be addressed- drug/alcohol misuse/mental health issues