Request Support for Yourself

HOW WE CAN HELP

Request Support for Yourself

If you would benefit from one or more of our services, we want to make it as simple as possible for you to get the right help.

Looking for support for a loved one? If you want to register for our services for a love one, please go to our Request Support for A Loved One page.

Eligibility & Catchment Checklist

Please use the quick-glance guide below to see which services are available in your area. You can click on the Detailed Eligibility Breakdown below the table to check the specific requirements for each project.

Service area

Available Services

Across Leicestershire

Harborough District

Eastern Side of Harborough District (Up to A5199)

Detailed Eligibility Breakdown

Someone relies on you for their care.
You are over 18 years old and care for someone who is also over 18.
The person you care for lives in Leicestershire. (Note: If they live in Leicester City, please contact Age UK).

You do not have access to your own transport and have difficulty using (or no access to) public transport.
You live on the east side of the A5199 within the Harborough District.
Your destinations are within Leicestershire, Northamptonshire, or Nottingham.
You are able to get in and out of a standard car independently.

You are aged 60 or over and live alone.
You live within the Harborough District.
You do not have a diagnosis of dementia or serious mental health issues.

You are aged 18 or over and live within the Harborough District.
You are experiencing mild-to-moderate mental wellbeing challenges and have a desire to make a positive change.

If you would prefer to have a casual chat with our staff before filling out the form, you can warmly contact us at 01858 456 042 or email wellbeing@vasl.org.uk.

Referral Form

Please complete the details below, and our project team will be in touch to discuss the service in more detail.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Your Details

Your Full Name*

(self-referral)

First Last

Your Phone Number*

Your Email Address*

Home Address

Please provide the address where the support or service is required

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

How Can We Help?

Which of our services are you interested in?*

(Select all that apply)

Support for Carers - Leicestershire

Car Scheme - Eastern side of Harborough

Community Champions (Befriending) - Harborough

Digital Support - Harborough

Community Wellbeing Harborough - Harborough

Please give a brief overview of how we can help

Thank you for taking the time to fill in these details. As soon as you click submit, our team will get to work. A member of our friendly project team will be in touch with you within 5 working days to discuss how we can best support you.

If you would like to download a form to fill in, please click here.

If you would like to download any of our project leaflets, please see our Leaflets page.

Request Support for Yourself

HOW WE CAN HELP