FORM OF REFERRAL/REQUEST

Children (leaving care) Act 2000

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Name of person making referral/request:

 

Name of Young person:


D.O.B:


Address:

 

Legal status: s.Children Act 1989

 

Young person’s advisor:

 

Aftercare Social Worker:

 

Responsible Local Authority:


1. Nature and level of contact and personal support to be provided.

 

 


2. Type of accommodation sought and approximate length of stay.

 

 

 

3. What is the plan for the education or training of the young person.

 

 


4. How will the responsible authority assist the young person in relation
to employment or other purposeful activity or occupation.

 

 


5. What support is needed to enable the young person to develop and
sustain appropriate family and social relationship.

 

 


6. What programme is needed to develop the practical and other skills
necessary for the young person to live independently.

 

 



7. The financial support to be provided in particular where it is provided
to meet the young person’s accommodation and maintenance needs.

 

 


8. Health needs, including any mental health needs, and how they are to
be met.

 

 


The Studio, 125 Washerwall Lane,
Werrington,
Stoke on Trent. ST9 0LY.


Tel: 01782 303640 Fax: 01782 305225 Email: info@springgarden.co.uk
www.springgarden.co.uk