Make a referral for a child or young person in need, or where there is reason to suspect they are likely to suffer significant harm because of abuse or neglect.
Please ensure that you have all the information needed to complete the form before you start. You will not be able to move forward to the next section of a form until all the mandatory fields are completed and you will not be able to save an incomplete form and complete it later.
With the exception of the key agencies section all sections of the form are mandatory.
Please contact us if you need to discuss the referral.
When you submit a completed form an acknowledgement page is displayed. The acknowledgement page displays the form’s unique reference number, you may wish to quote this if you contact us about the referral.
Saving a copy
If you wish to print a copy of the form you must do it by clicking the button on the acknowledgement page. Once you leave the acknowledgement page you will not be able to return to it to print a copy of your form.
Thresholds of need
Children and their families have different levels of need that may change over time. We have identified what to do when a threshold (or trigger) has been reached, indicating when a child, young person or family might need support, and then to identify where best to get this support from.