Kinship Reach self-referral form

We are here for you and your family over the next few months, helping to ease your worries and support you through these strange times.

Kinship is an independent and non-judgmental charity. We can support you for free in various ways – giving advice and support on any problems you are having as a kinship carer.

Please complete the form below to tell us a bit about your situation - it will take about 5-10 minutes - and means we can get the right support to you quicker.

Please read the data protection section of this self-referral for more information on circumstances which would mean we need to share information.

About you:

What type of legal order or status do you have for the care of the child you are looking after, or do you have ongoing court proceedings?

What area do you live in?

Is your order from the same local authority in which you live?

If ’other’ please give details:

If no, please choose which local authority your order is from:

Support Available:

Note to Programmes Coordinator / Advice Service:

This is West Yorkshire One Adoption, Adopt North London and Southwark who have bought Kinship Connected.

How we can help:

We can give you expert advice and support through our either our Kinship Connected programme or our Kinship Reach programme. Through these programmes we can offer one-to-one support with our project worker as well as priority access to our other services.

They’ll listen to what might be worrying you at the moment and they’ll help.

What happens next:

· One of our project workers will ring or text you in the next five working days to set up a time to talk at a time that works best for you.

· At that time, they’ll talk through some questions, listen to you and help you with your immediate needs.

The same project worker will check in with you to see how you are doing over the next few months.

What are the main things that you are worried about at the moment?

Please add just a little bit more detail about what you need help with so that we have some background information when we call you.

This just helps our project worker so they can support you better when they chat to you:

Support Available:

Note to Programmes Coordinator / Advice Service:

This is a Kinship Membership and therefore no access to one-to-one project worker support or digital skills.

We can help you through our advice team. They will be able to help you if would like some help accessing things like benefits, or if you have a problem with housing or employment.

What happens next:

Fill out the form below and either one of our advice line workers will ring you in the next three to five working days and talk through your needs.

Please add just a little bit more detail about what you need help with so that we have some background information when we call you:

Case record Type

Your Details:

Your first name:

Your last name:

Home Phone:

Mobile Phone:

Email (you’ll receive a confirmation email when you submit your form):

Address:

Country

Postcode:

Your date of birth (in this format 19/02/1965):

How many kinship children are in your care?

What is your relationship to the child/children?

Other relationship

How did you hear about us?

If other, please specify how you heard about us

I would like to join the Kinship Carers Community of over 7,000 kinship carers. (If you tick 'yes', you'll receive emails around events, advice, useful organisations and other relevant information for special guardians and other Kinship Carers.)

Data protection:

Kinship is committed to making only responsible use of your data.

From time to time you may wish us to discuss your case with other agencies. This may involve finding out information on your behalf. For example, if you are making an application for specific services, the authority or organisation which processes your application may require more information about you from us.

For further details you can view our privacy policy at https://www.kinship.org.uk/privacy-policy

Your consent:
Please tick the box here to confirm you agree with our data protection policy.

I agree

By pressing the submit button below, you are confirming that you have permission for us to contact you directly about Kinship Reach.

Contact Information