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Proof of a referral to a domestic violence support service

Use this letter to get proof that an appropriate health professional referred you to a domestic violence support service, if you're applying for legal aid.

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To get proof of a referral to a domestic violence support service, you should:

  • fill in the sample letter as much as you can
  • send it to the support service or to the health professional who referred you

You can use this as evidence if you’re applying for legal aid to help you divorce or separate from an abusive partner.

If you’re part of an organisation offering specialist support to victims of domestic violence you can adapt this letter to give information about referrals made by health professionals, including doctors, nurses, midwives, dentists, practitioner psychologists, paramedics, radiographers and social workers.

You can adapt this sample letter if you’re an appropriate health professional and have been asked to provide evidence of referring someone to a specialist domestic violence support service.

You can also use this sample letter if you’re an appropriate health professional and have access to relevant medical records but did not make the referral yourself.

Published 19 December 2014