Duty To Refer For Public Authorities

This referral is ONLY to be used by staff from Specified Public Authorities, as listed below

Is this your first referral?

Please read the  Dorset Duty to Refer Protocol before you start.

To make a referral 

Step one

Complete one of the following forms to provide supporting evidence, risk factors and other essential information.

A referral cannot be assessed without the supporting evidence.

  • Duty to Refer NHS clinical evidence Use this short, simple form to provide clinical supporting evidence. If you have more background information on the person you are referring, please use the 'all agencies' form, below.
  • Duty to Refer supporting evidence Use this longer, more detailed form for supporting evidence. 

Email the completed form to:  


IMPORTANT: Make sure you put the person’s name in the subject line of the email. Failure to do so will result in delays.

Step two

This is for use by the following authorities only 

  • Prisons
  • Youth offender institutions
  • Secure training centres
  • Secure colleges
  • Youth offending teams
  • Probation services (including community rehabilitation companies)
  • Jobcentre Plus
  • Social service authorities
  • Emergency departments
  • Urgent treatment centres and;
  • Hospitals in their function of providing in-patient care
  • The Armed Forces – the Royal Navy, the Royal Marines, the Army and the Air Force