Kinship Local Authority Advice Referral Only
This referral is for local authorities who have funded Kinship Membership.
This includes the following services:
Referred kinship carers will receive a response from one of our advisors within 3 working days.
Kinship Carer Details:
First Name:
Last name:
Email:
Phone Number:
What is the kinship carer's relationship with the child/children?
Please select...
Grandparent
Aunt/Uncle
Sibling
Other Relative/ Friend
Unknown
Kinship Carer
Great Grandparent
Kinship Carers Gender:
Please select...
Male
Female
Other
Non-binary
Prefer not to say
Kinship Carers Marital Status:
Please select...
Married
Single
Widowed
Living with partner
Living on own
Prefer not to say
Divorced
Seperated
Other
Kinship Carers Ethnic Group?
Please select...
Asian or Asian British - Bangladeshi
Asian or Asian British - Chinese
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Other Asian Background
Black British
Black or Black British - African
Black or Black British - Caribbean
Black or Black British - Other Black background
Black or Black British - Other ethnic Background
Mixed Heritage - Other
Mixed Heritage - Other Dual Heritage background
Mixed Heritage - White and Asian
Mixed Heritage - White and Black African
Mixed Heritage - White and Black Caribbean
Mixed Heritage - White and Chinese
White - English
White - Northern Irish
White - Scottish
White - Welsh
White - Gypsy/Roma/Traveller
White - Irish
White - Other White Background
Other
Prefer not to say
Kinship Carers Age Category:
Please select...
Under 20
20-24
25-34
35-44
45-54
55-64
65-74
75-84
85+
Kinship Carers Sexual Orientation:
Please select...
Heterosexual
Lesbian
Gay
Bisexual
Prefer not to say
What are the support needs of the carer?
Do they have a legal order or status for the care of the child they are looking after, or do they have ongoing court proceedings?
Please select...
Special Guardianship Order
Residence order
Kinship Foster Carer
Child arrangement order
No legal order / informal arrangement
Foster carer
Adoption order
Interim care order
Supervision order
Private Foster Carer
Not sure
Other
Were Children's Services involved in the placement of the child/ children in this kinship care arrangement?
Please select...
Yes
No
Not Sure
Are there any Safeguarding Issues?
Please select...
Yes
No
Not sure
If yes or not sure, please provide details
Your details as the referrer:
First Name:
Last Name:
Job Title
Email (you'll receive a confirmation email when you submit the form):
Date of referral:
Local Authority
Please select...
Barking and Dagenham
Barnet
Birmingham
Bradford
Brent
Bromley
Calderdale
Camden
Durham
Ealing
East Riding of Yorkshire
East Sussex
Enfield
Gateshead
Hackney
Hammersmith and Fulham
Hampshire
Haringey
Havering
Hounslow
Islington
Kingston Upon Hull, City of
Kirklees
Leeds
Newcastle Upon Tyne
Newham
North East Lincolnshire
North Yorkshire
Redbridge
Sefton
Southwark
Surrey
Tower Hamlets
Wakefield
Walsall
Waltham Forest
Wirral
York
Contact Information