Practitioner/ professional referral - Child and Family Service

Practitioner request for information, advice and assistance from the Early Help Hubs or the Single Point of Contact at Swansea Council.

To assist with filling in the practitioner request please refer to the continuum of need documentation.

Are there any immediate safeguarding concerns? If there are please ring 999 and call any immediate safeguarding worries through to SPOC on 01792 635700 or EDT 01792 775501. Your referral can be subsequently forwarded.

This online form will time out after 20 minutes to protect your data. To make sure you don't lose the information you have entered you should save the form as you complete it. The saved form will be available for 28 days to complete and submit.

This form is available in Welsh - click on 'Cymraeg' in the top right corner of your screen.

Swansea Council is the data controller for the personal information you provide on this form. Your information will be used in the exercise of our official authority and will not be used for any other purpose. We will not share your data with third parties unless we are required or permitted to do so by law.

Data protection law describes the legal basis for our processing your data as necessary for the performance of a public task. For further information about how Swansea Council uses your personal data, including your rights as a data subject, please see our corporate privacy notice on our website.
Consent/ authorisation
1. Has consent/ authorisation been obtained?*
  
  Yes
  
  No
2. Has this referral been previously discussed with SPOC in the last 48 hours?
  
  Yes
  
  No
3. If yes, who did you speak to?
4. To continue with this form you will need to contact SPOC on 01792 635700 or EDT on 01792 775501.
5. Is this request for*
  
  Early Help
  
  Safeguarding
  
  Carers assessment
  
  Equilibrium
6. Team email
Referrer details
1. Date of request
2. Name of practitioner/ professional making request*
3. Name of agency*
4. Agency address
  1. Label
    
    Address
    
    Postcode lookup*
    
    Address
  5. County
  6. Postcode
5. Telephone*
6. Email*
1. If you want to save this form, please ensure you have entered your email address above to receive the link in order to continue it later.

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Last modified on 19 February 2024

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Practitioner/ professional referral - Child and Family Service

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