Refer a kinship carer: Kinship Connected Please use the form below. Local Authority Kinship Carers Referral Form Page 1 Name of Local Authority:Please select... Barking and Dagenham Barnet Barnsley Bath and North East Somerset Bedford Borough Bexley Birmingham Blackburn with Darwen Blackpool Blaenau Gwent Bolton Borough Bournemouth Bracknell Forest Bradford Brent Bridgend Brighton and Hove Bristol, City of Bromley Buckinghamshire Bury Caerphilly Calderdale Cambridgeshire Camden Cardiff Carmarthenshire Central Bedfordshire Ceredigion Cheshire East Cheshire West and Chester City Of London Conwy Conwy County Borough Cornwall Coventry Croydon Cumbria Darlington Denbighshire Derby Derbyshire Devon Doncaster Dorset Dudley Durham Ealing East Riding of Yorkshire East Sussex Edinburgh City Enfield Essex Flintshire Gateshead Gloucestershire Greenwich Gwynedd Hackney Halton Hammersmith and Fulham Hampshire Haringey Harrow Hartlepool Havering Herefordshire Hertfordshire Hillingdon Hounslow Hull City Inner London Inverclyde Isle of Anglesey Isle Of Wight Isles Of Scilly Islington Kensington and Chelsea Kent Kingston Upon Hull, City of Kingston Upon Thames Kirklees Knowsley Lambeth Lancashire Leeds Leicester Leicestershire Lewisham Lincolnshire Liverpool Luton Manchester Medway Towns Merthyr Tydfil Merton Middlesbrough Milton Keynes Monmouthshire Moray Neath Port Talbot Newcastle Upon Tyne Newham Newport Norfolk Northamptonshire North Ayrshire North East Lincolnshire North Lincolnshire North Somerset North Tyneside Northumberland North Yorkshire Nottingham Nottinghamshire Oldham Oxfordshire Pembrokeshire Peterborough Plymouth Poole Portsmouth Powys Reading Redbridge Redcar & Cleveland Rhondda Cynon Taf Richmond Upon Thames Rochdale Rotherham Rutland Salford Sandwell Sefton Sheffield Shropshire Slough Solihull Somerset Southampton Southend-on-Sea South Gloucestershire South Tyneside Southwark South Yorkshire Staffordshire St Helens Stockport Stockton-On-Tees Stoke-On-Trent Suffolk Sunderland Surrey Sutton Swansea Swindon Tameside Telford and Wrekin Thurrock Torbay Torfaen Tower Hamlets Trafford Vale of Glamorgan Wakefield Walsall Waltham Forest Wandsworth Warrington Warwickshire West Berkshire Westminster West Riding West Sussex Wigan Wiltshire Windsor and Maidenhead Wirral Wokingham Wolverhampton Worcestershire Wrexham York Name of Programme:Please select... Kinship Connected Barnet 2020-21 Kinship Connected Bradford 2020-21 Kinship Connected Bromley 2020-21 Kinship Connected Calderdale 2020-21 Kinship Connected Camden 2020-21 Kinship Connected Enfield 2020-21 Kinship Connected Hackney 2020-21 Kinship Connected Haringey 2020-21 Kinship Connected Islington 2020-21 Kinship Connected Islington Families 2020-21 Kinship Connected Kirklees 2020-21 Kinship Connected Leeds 2020-21 Kinship Connected Newcastle-upon-Tyne 2020 Kinship Connected Southwark 2020-21 Kinship Connected Wakefield 2020-21 Kinship Connected Walsall 2020-21 I can't see my area Kinship Connected is not currently available in this area. However, you can contact our advice service for support via our online form or on 0300 123 7015.Please use the link above or call us and do not continue with the form. Page 2 Carers Information Date of referral First Name Last Name Date of birth (in this format - 19/02/1965) Telephone Mobile Address Line 1 Postcode Email What is the priority need? Please select... Improving relationships with family members Reducing isolation through sharing experiences and meeting peers Reducing financial concerns through sign posting Reducing levels of concern with children's behaviour Enhancing confidence to cope in their caring role What are the current support needs? Preferred method of contact? Please select... All Mobile Home Phone Mobile or Home Email Text How many kinship children are in their care? Please select... 1 2 3 4 5 6 6+ How long have children been in their care (in years)? Please select... Under 1 year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Is there a special guardianship order in place?Please select... Yes No Don't know 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. Please select... Yes No If yes, please detail: Page 3 Referrers Details Your First Name Your Last Name Job Title Organisation/LA Address First Line Postcode Email 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.)Please select... Yes No I am a Grandparents Plus Project Worker filling this in for a LA.Please select... Yes No 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 policyI Agree By pressing submit, you are confirming that you have permission to add this kinship carer and for us to contact them. Contact Information
