Chance UK Referral Form

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This form is part 1 of a 2 part referral form for Chance UK's programmes. Part 1 below will establish basic eligibility. Part 2 will ask for details about the family and how we may support them.

Referrals are OPEN for Explore & Empower in Islington only.

Referrals are CLOSED for STEP, Explore & Empower in Lambeth and our My Future programme.

Please scroll down to complete the questions. Due to the COVID-19 pandemic, there is likely to be a waiting time after referral and before mentoring begins.

Please note, we have reached capacity for referrals with Autistic Spectrum Condition and cannot accept any more of these referrals in this intake.


The programme supports families with children who display challenging behaviour. 
Newly referred families, with a child meeting our behavioural threshold are entitled to access: 
  • Children will receive up to 9 months of input from a Chance UK mentor and staff. 
  • Families and mentors agree to adhere to Chance UK's policies around safe sessions during the Covid-19 pandemic. Children can have in-person 1:1 sessions in the community following guidelines if it's safe to do so, or remote 1:1 sessions if it's not. 
  • Parents and carers will have 1:1 support and group options from our Family Support team 
  • Chance UK Programme Managers will provide remote contact with the child before they can be matched with a mentor.
  • With Chance UK’s support, children and mentors will identify the child’s strengths, use solution-focused talking tools to improve issues, and make and complete goals. Families will review and support these changes and progress, have support to access group work from Chance UK as well as the option of accessing support from other organisations. 
  • Families will graduate from the programme after 9 months. After this, all contact between the family and the mentor will stop after graduation. 


ELIGIBILITY QUESTIONS




To work with Chance UK, families must agree and select YES to following this policy and treating all staff and volunteers fairly.

CHILD









REFERRER











SCHOOL OR OTHER PROFESSIONAL BEHAVIOURAL ASSESSMENT
Goodman Strengths and Difficulties Questionnaire (SDQ)
Copyright Robert Goodman 1997. Permission granted for use.
Please rate the child’s behaviour over the last six months, or over the last school year,
by selecting one answer in each row below.


Not True Somewhat True Certainly True
MAIN CARER BEHAVIOURAL ASSESSMENT
Goodman Strengths and Difficulties Questionnaire (SDQ)
Copyright Robert Goodman 1997. Permission granted for use.
Please rate the child’s behaviour over the last six months, or over the last school year,
by selecting one answer in each row below.


Not True Somewhat True Certainly True