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Make a referral to the Connecting Families team

At the Early Help Allocation Panel (EHAP), where all Connecting Family referrals go to, there are a range of other services offering support. They include:

If any of these services are relevant to your request, please refer directly to that service.

We recommend that you read our web page to check if the child, young person or family is eligible for help before completing this form.

Request help for a child, young person or family who has multiple or complex needs and needs help to achieve positive outcomes.

Completing this form should take 5 to 10 minutes.

Document uploads

You can upload copies of any files that are relevant to the referral as long as you have the family's permission. These might include the following:

  • SERAF
  • Save Lives questionnaire
  • Healthy Relationship questionnaire
  • Any previous assessments that have been compiled

You can use any of these file formats for your uploads: jpg, pdf, png, doc, docx,

cover_page
[webform_submission:values:full_name]
[webform_submission:values:service_or_agency_you_work_for]
[webform_submission:values:your_job_title]
[webform_submission:values:your_role_within_the_family]
[webform_submission:values:are_you_currently_the_lead_practitioner_:raw]
[webform_submission:values:contact_email_address]
[webform_submission:values:contact_telephone_number]
[webform_submission:values:address]
[webform_submission:values:do_you_have_consent_the_family_willing_to_engage_and_residency_c:raw]
[webform_submission:values:family_surname]
[webform_submission:values:contact_email_address_family]
[webform_submission:values:contact_telephone_number_family]
[webform_submission:values:address_family]
[webform_submission:values:please_tell_us_who_holds_parental_responsibility:raw]
[webform_submission:values:family_members]
[webform_submission:values:do_all_of_these_people_live_at_the_same_address_as_the_family_:raw]
[webform_submission:values:family_members_addresses]
[webform_submission:values:please_tell_us_which_criteria_the_family_meet:raw]
[webform_submission:values:good_education_details]
[webform_submission:values:criteria_early_years:raw]
[webform_submission:values:early_years_details]
[webform_submission:values:criteria_mental_physical_health:raw]
[webform_submission:values:mental_physical_health_details]
[webform_submission:values:criteria_substance_abuse:raw]
[webform_submission:values:substance_use_details]
[webform_submission:values:criteria_family_relationships:raw]
[webform_submission:values:family_relationship_details]
[webform_submission:values:criteria_abuse_exploitation:raw]
[webform_submission:values:abuse_exploitation_details]
[webform_submission:values:has_a_seraf_been_completed_:raw]
[webform_submission:values:criteria_tackling_preventing_crime:raw]
[webform_submission:values:tackling_preventing_crime_details]
[webform_submission:values:criteria_domestic_abuse:raw]
[webform_submission:values:safe_from_domestic_abuse_details]
[webform_submission:values:has_a_save_lives_questionnaire_has_been_completed_:raw]
[webform_submission:values:criteria_domestic_abuse:raw]
[webform_submission:values:secure_housing_details]
[webform_submission:values:criteria_financial_stability:raw]
[webform_submission:values:financial_security_details]
[webform_submission:values:concerns_detail]
[webform_submission:values:impact_details]
[webform_submission:values:working_well_details]
[webform_submission:values:please_indicate_what_service_the_family_would_benefit_from_the_m:raw]
[webform_submission:values:please_tell_us_which_of_the_following_will_be_required:raw]
[webform_submission:values:please_tell_us_which_sign_language_you_require:raw]
[webform_submission:values:please_tell_us_which_language_you_require:raw]
[webform_submission:values:something_else_details:raw]
[webform_submission:values:tell_us_about_any_risks_we_should_be_aware_of_if_we_visit_the_fa:raw]
[webform_submission:values:do_you_know_if_there_have_been_any_assessments_made_in_the_last_:raw]
[webform_submission:values:assessment_details]
[webform_submission:values:do_you_know_of_any_previous_support_accessed_or_offered_in_the_p:raw]
[webform_submission:values:previous_support_details]
[webform_submission:values:do_you_know_of_any_other_professionals_involved_:raw]
[webform_submission:values:other_professionals_details]