Kinship Reach: Local authority referral

This referral form is for local authorities who have commissioned Kinship Reach.

This includes the following services below:

Local authority details:

Commissioning regional adoption agency name:

Name of local authority:

All one to one project worker support referrals for 2022-2023 for this area have now be received. However, you can continue this form if you would like to refer carers for Kinship Membership support.

Your details as the referrer:

Your first name:

Your last name:

Job title:

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

Date of referral:

Special guardian’s information:

First name:

Last name

Home Phone:

Mobile Phone:

Email:

Date of Birth (in this format - 19/02/1965)

Address

Country

Postcode

How many kinship children are in their care?

Does the carer have a legal order or status for the care of the child they are looking after, or do they have ongoing court proceedings?

What are the current support needs?

Are there any Safeguarding Issues

Please supply more details regarding the safeguarding issues

Professionals Network:

I would like to join Kinship’s Professionals Network. (If you tick yes, you'll receive emails about events, best practice, new reports, and other relevant information about special guardians and other kinship carers.)

Data protection and consent:

Kinship is committed to making only responsible use of your data. The information you share with will only be used to respond to you directly by our experts. We will not share your data with any third parties.

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

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

I agree

By pressing submit below, you are confirming that you have permission to add this special guardian and for us to contact them directly.

Case Record Type

Contact Information