Refer a kinship carer: Kinship Connected

Please use the form below.

Local Authority Kinship Carers Referral Form

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Name of Local Authority:

Name of Programme:

Date of referral

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Carers Information

First Name

Last Name

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

Telephone

Mobile

Address Line 1

Postcode

What is the priority need?

What are the current support needs?

Preferred method of contact?

How many kinship children are in their care?

How long have children been in their care (in years)?

Is there a special guardianship order in place?

Do project workers need to be aware of anything that may be a risk to their safety when working with the carer? This could include when making a home visit.

If yes, please detail:

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Referrers Details

Your First Name

Your Last Name

Job Title

Organisation/LA

Address First Line

Postcode

Contact Number

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

I am a Grandparents Plus Project Worker filling this in for a LA.

Data protection - Grandparents Plus 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 3rd parties. For further details you can view our privacy policy at https://www.grandparentsplus.org.uk/privacy-policy

Data protection - please tick the box here to confirm you agree with our data protection policy

I Agree

By pressing submit, you are confirming that you have permission to add this kinship carer and for us to contact them.

Contact Information

Local Authority Kinship Carers Referral Form

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