Parents as Partners Self- Referral Form

In order to progress with the application we require both parents to be willing to attend Parents as Partners sessions together.  Please have a conversation with your co-parent and come back to us if you both agree to proceed with this application.
Personal Details- Parent 1

GP Details
We ask for your GP details to enable us to arrange support in the event of an emergency, or to support access to local statutory services for better coordinated care if this was thought to be helpful.  If we need to liaise with your GP will we discuss this with you first. 

Registration Continued

Name Age
Child 1
Child 2
Child 3
Child 4

Parents as Partners

Parent 2
To enable us to register your co- parent for this service, please provide us with their contact information.  It is important you obtain their consent to sharing this information with us. 

Co-Parent GP Details

Please say what times on a Thursday you are both available to attend group sessions together:  

Please click "Next Page" to proceed
Data Protection
The privacy of our clients is paramount. Please read our privacy notice on how we use and store your information, and confirm that you consent to us using your personal information as described.

Questions or concerns?
Please speak to a member of staff in order to proceed with your referral 0207 380 1960
Please click "Next Page" to proceed

You will then be contacted by one of the Parents as Partners team who will arrange to meet you both for an initial consultation. 

In the consultation you will meet the Group Leaders, who will ask you a little more about your reasons for wanting to participate and what you would hope to get from the programme.   If after the consultation session we all agree this is the right support for you at this time, you would be invited to join a group. 

The group sessions are online, last for 2 hours and run for 16 weeks and regular attendance is important if you are to get the most out of the programme. 

Please click submit to complete your referral.