Form

Proof of a referral to a domestic abuse support service

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

• From: Legal Aid Agency
• Published: 31 July 2025

Applies to England and Wales

Documents

Sample letter to confirm you were referred to a specialist domestic abuse support unit

MS Word Document, 23 KB

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Details

To get proof of a referral to a domestic abuse 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 abuse 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 abuse 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 31 July 2025