Equality, Accountability, Caring, Creative, Collaboration, Learning and Community

Page 1

POCAR Referral

The overall aims of POCAR are:


·        1.  Support parents to address drug and alcohol difficulties to achieve their                   parenting goals.

·        2. Enhance safety and stability for children.

·        3. To increase parents’ self-esteem and confidence.

·        4. Reduce isolation and build resilience. 

Please tell us more about the family you are referring. We aim to contact the parent within 2 weeks of receiving this referral. 

Parent details (We will use these to contact the parent. Please complete a separate referral if referring more than one parent or carer – POCAR has separate programs for men and women)








Page 2

Children’s details (We need these to understand the family and for our safeguarding procedures. We will not contact the children or any carers without further discussion and consent)

    Full Name   Date of Birth         Age (at time of referral)   Legal Status    with Children's   Services (CPP,   CIN, LAC etc.)
1
2
3
4
5

Please help us build a picture of the family by providing the following information about current family circumstances: 

Pen Picture for the children – briefly outline important information relevant to this referral. 







Page 3

Pen Picture for the adults – please provide brief details as a starting point to help us understand the parent’s experiences leading to this referral. Guiding questions in Italics.








Page 4




Briefly summarize what will help us start working effectively with this family, understand priorities and agree timeframes for goals.





Page 5

Referrer Details