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Sophie’s Story
The legacy
About Us
Hospitals we serve
Events
- Upcoming Events
- Supermarket Days
News & Media
- Blog
- Media
- Podcast
Ways to help
Shop
Contact

Referral Form for Children’s Wards

* If transport is required please use the separate transport referral form *

Any questions please call: Janine – 07354 842309 / Stephanie – 07842 411306

Our office hours are 9.30am to 2.30pm Monday – Friday

Reason for Referral

Clothes (Pyjamas / Underwear / Day Clothes) Birthday or Special Event (please use the box below to detail your requests) Petrol Vouchers Anything Else (please detail in the box below)

Parent Name

Parent Mobile Number

Parent Email

Parent Ethnicity

Hospital you are attending

Child Name

Child DOB

Child Gender

Child Ethnicity

Sibling Details (if support needed)

Area Family Live: (nearest town)

It Is Important To Keep Everyone Safe Including Our Team. Please Answer The Following:

Are they or anyone in the household a victim of domestic violence?

Yes No

Do they or anyone in their home have an offending history?

Yes No

Are they known to Social Services?

Yes No

Are The Family Aware A Referral Has Been Made?

Yes No

Family Consent Given:

Yes No

Name of Person Making Referral

Contact Number of Person Making Referral

Email Address of Person Making Referral

Details of Referral: (Please provide as much specific detail as possible so we know what is needed from us)

Listen to the Sophie's Legacy Podcast!

The Sophie’s Legacy Podcast is where purpose meets action. From Sophie’s journey and the growth of the charity to inspiring conversations with volunteers, changemakers, healthcare professionals, and women in business, we share the stories behind creating real impact. Join us for honest discussions, powerful experiences, and the people helping to fulfil Sophie’s wishes and build a kinder future for children and families.

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About Us

Sophie’s Story
Hospitals We Serve
Events
News & Media
What we do
Ways to help
Shop
Annual Report

Sophie’s Story
Hospitals We Serve
Events
News & Media
What we do
Ways to help
Shop
Annual Report

The Legacy

Play specialist
Improvements to food
Parents to be fed
Trained health professionals
Increase funding
Q&A

Play specialist
Improvements to food
Parents to be fed
Trained health professionals
Increase funding
Q&A

Get In Touch

info@sophieslegacy.org.uk
Segensworth Office Park, 4 Little Park Farm Rd, Fareham PO15 5TD

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Site by Idio