South Yorkshire Sexual Violence Partnership

South Yorkshire Independent Sexual Violence Service

This form is for individuals and professionals wishing to a make a referral for support from an Independent Sexual Violence Advisor (ISVA)

Personal Information

Authorised methods of contact

Please check the methods we can use to make contact.*

Risk Information

Referrer Details *

Professional Referral Details

*South Yorkshire Police Referrals ONLY*

We are unable to accept referrals where explicit consent has not been given.

Child or Young Person Referrals Only

If this referral is for a child or young person under 16, please provide the name of the safest contact- Parent / carer or guardian for us to contact in the first instance.

Incident Details

Monitoring Information

To complete the referral process, we need to collect some basic monitoring information. This helps us improve our services and is a requirement of our funders.

The details provided will be reported anonymously.

Data Protection

The data provided on this form is used to identify clients and assist the ISVA worker when contacting agencies as part of their advocacy role. This data on this form is treated as both 'personal' and 'sensitive' and subject to the policies of the local ISVA service provider with respect to confidentiality and data protection.

SRASAC acts as a 'data processor' on behalf of BSARCS, ROTHACS and DRASACS in order to refer clients into the appropriate local ISVA service provider. BSARCS, ROTHACS, SRASAC and DRASACS act as 'data controllers' for ISVA clients within their local area.