Take part in Live Well Community Referral

Referral Form

Please complete the form below and a member of our team will be in touch with you within three days. Answers are voluntary unless marked with a red asterisk - this information is required in order to process your referral.

Referral Form
Prefer to self-describe

If you'd prefer to be contacted by email, please enter your email address below:

If you'd prefer to be contacted by phone, please enter your phone number below:

Other reason

(Any additional support required, best time to contact you etc)


For your peace of mind, the details you send to us using this form will be securely encrypted. Please read our Privacy Statement below for more information.

If you are under 13 years of age, your parent or guardian will need to complete this form to allow us to use the information.

View our specific privacy notices, general privacy notice and privacy statement.

Specific Privacy Notice

General Privacy Notice

Privacy Statement

Who May Process Your Personal Data?

The information which you provide on this online form will be processed by Culture and Sport Glasgow**, which is a data controller of this information for the purposes of the General Data Protection Regulation 2018. Glasgow Life is the operating name of Culture and Sport Glasgow.

For What Purposes Will Your Personal Data Be Used?

Information you provide on this online form will be used by Culture and Sport Glasgow** for the Live Well service.