© The Exaireo Trust Limited

Registered Charity number: 1125402

Restored - Released - Renewed


If you wish to refer someone for a residential place with Exaireo, the following forms should be completed in full.

1) Agency Referral Form

2) Equal opportunities Form

3) Risk Profile Form

These forms can be downloaded by clicking the links below. They can either be scanned and emailed or posted back to Exaireo.

Agency Referral Form

Agency Referral Form Guidance Notes

Equal Opportunities Form

Risk Profile Form

If you would like to complete a referral for yourself please use this form

Self Referral Form

01509 266422

The Exaireo Trust Limited

39 Granby Street,


LE11 3DU