Make a Referral

At Serenity we provide exceptional levels of care and support for our Service Users. You can make a direct referral to us and we will be happy to help.

Please fill out our form below and we'll be in contact:

Referral to Broker Domiciliary Care

Service User Name:*
Date of Birth:*
 / 
 / 
House Number / Name:*
Address:*
Paris ID No:
Swift ID No:
NHS No:
Proposed start date:*
 / 
 / 
Proposed First Call:

Key Service Information

Type of Care

Emergency Care:
Continuing Health Care:
End of Life:
Generic Care:
Re Ablement:
Please tell us further information about your care needs:

Type of Referral

Council Referral:
Private Referral:
NHS Referral:
Managed Account:
Direct Payment:

Referrer Information

Referrer Name:*
Organisation:*
Organisation Address:*
E-mail:*
Mobile Telephone Number:
Landline Telephone Number:
-
Date of Referral:*
 / 
 / 
Word Verification:

Business Hours

Main Telephone: 0121 250 3611
We operate a 24 hour service every day throughout the year.

Our office hours:
Monday-Friday: 9am to 5pm

Out of office hours:
Please telephone 0121 250 3611 and you will be directed to the Oncall Manager.

Our Address

Serenity Homecare Ltd
Quayside Tower
252 – 260 Broad Street
Birmingham
West Midlands B1 2HF

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