Care Plus Transitions Referral Enquiry Form Care Plus Transitions receives a large volume of referrals each month for the services it provides to young people in Care. In response to the high volume of referrals Care Plus Transitions has created an online referral system for Local Authorities which will eliminate clunky paperwork, streamline and speed up the referral process for Young People requiring services. Our online referral system will allow Local Authorities to make a referral for a young person in under 10 minutes. If you wish to make a placement referral for your young person, please complete the online Referral Enquiry Form and we will respond to it within 2 hours 1. Details of person being referred Name of Young Person Being Referred* Date of Birth* Contact Number* Current Address* Care Status of Young Person* 2. Who is making the Referral Full Name* Local Authority* Contact Number* Job Title* Email Address* Mobile Contact Number If you are unavailable is there someone we can contact in your absence? Full Name Contact Number Email Address Mobile Contact Number 3. Please give the reasons for making their referral Please indicate current accommodation and support needs* 4. Is the Referral for a specific service (E.g. Group Living, Solo Accommodation, Farm Project, Equine Programme, Therapeutic Interventions, if yes please specify below) 5. If the Referral isn’t for a specific service, what type of service are you making a Referral to? (Consider for example: staffing levels to meet the individual’s needs, gender specific, culturally specific, geographical location etc.) 6. How urgent is the Referral? Level 1 (Urgent) – for example the person is at risk in their current accommodation, homeless; the person is a delayed discharge from Custody/Secure Unit etc. Level 2 (Standard) – for example the person is ready for move on from their current accommodation, their needs have changed but they are not at risk in their current accommodation, they wish to move nearer their family/social network etc. Please state which level and why this is the case What we need from you Please upload a copy of an up to date Risk Assessment [recaptcha] At Care Plus Transitions we take your privacy very seriously. Your data will be stored on our email database and will only be used to contact you for the reason you are enquiring on this form, or to process your job or volunteering application. By ticking this box you agree to our terms and conditions and can view more information in our Privacy Policy. For more information on any of our services please get in touch today CONTACT US