№ files_lp_4_process_2_78630
File format: docx
Character count: 1732
File size: 48 KB
Structured form for referring children and families to specialized support services, capturing personal, family, and support-related information along with parental consent.
Year:
2026
Region / City:
United Kingdom
Document Type:
Referral Form
Organization:
Pandora Project
Author:
Unknown
Target Audience:
Parents and guardians of children aged 5-6 years and older
Date of Referral:
2026
Required Prior Support:
Thrive sessions or play therapy for children aged 5-6 years
Support Needs Categories:
Behavioural, ADHD, Autism, Learning Difficulties, Physical health needs, Offending support needs
Parental Needs Categories:
Drug dependency, Alcohol dependency, Mental health needs
Family Disability Information:
Collected if applicable
Resident Details:
Full name, Relationship to client, Date of birth
Other Agencies Involved:
Collected with organization name, contact name, and telephone number
Consent:
Required from parent or guardian
Referrer Details:
Name, Job title, Agency, Email, Telephone
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Note:
Year
Theme:
Mental Health
Document Type:
Information Sheet
Organization / Institution:
Gloucestershire Health & Care NHS Foundation Trust
Target Audience:
Children and Young People (CYP), parents, carers, and professionals
Description:
This document provides crisis intervention contacts and resources for children and young people experiencing mental health crises in Gloucestershire.
Year:
2023
Region / City:
Doncaster
Topic:
Mental Health and Wellbeing
Document Type:
Strategy
Organization:
Doncaster Borough Council
Author:
Not specified
Target Audience:
Children, young people, families, healthcare providers, mental health professionals
Action Period:
2023-2025
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Region / City:
England
Topic:
Mental Health
Document Type:
Curriculum
Organization / Institution:
NHS England
Author:
Not specified
Target Audience:
Children and Young People’s Mental Health Practitioners
Period of Validity:
Not specified
Approval Date:
18 March 2024
Date of Changes:
Not specified
Year:
Not specified
Region / city:
Not specified
Topic:
Job application, Counselling, Mental health
Document type:
Application form
Organization / institution:
Listening Ear
Author:
Not specified
Target audience:
Individuals applying for the CYP Counsellor position
Validity period:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2024
Region / City:
North Lanarkshire
Subject:
Community support, Mental Health and Wellbeing
Document type:
Application Form
Organ / Institution:
Voluntary Action North Lanarkshire
Author:
Voluntary Action North Lanarkshire
Target audience:
Community and Voluntary Sector organisations
Period of validity:
2024-2025
Approval date:
N/A
Change date:
N/A
Context:
Application form for CVS organisations seeking funding for Phase 5 of the CYP MHWB Fund to support mental health and wellbeing projects.
Year:
2026
Region / City:
Juno Women’s Aid premises
Subject:
Domestic Violence and Abuse, Young People Support
Document Type:
Job Description
Organization:
Juno Women’s Aid
Author:
N/A
Target Audience:
Professionals working with children, young people, and families affected by domestic violence
Period of validity:
N/A
Approval Date:
N/A
Modification Date:
N/A
Context:
Detailed job description for a position supporting children and young people affected by domestic violence, including responsibilities, qualifications, and skills required.
Note:
Year
Year:
2024
Region / City:
Manchester
Theme:
Risk Assessment
Document Type:
Risk Assessment Report
Organization:
Royal Exchange Theatre
Author:
Scarlett Spiro-Beazley
Target Audience:
Staff, Participants, Freelance Practitioners
Effective Period:
Ongoing
Approval Date:
April 2024
Next Assessment Due:
February 2027
Note:
Year
Organization / Institution:
YMCA DownsLink Group
Year:
2024
Region / City:
Hertfordshire
Topic:
Emotional distress management in children and young people
Document type:
Medical guideline
Organization:
Hertfordshire GP
Author:
Dr Alison Cowan
Target audience:
General Practitioners, Mental Health Professionals
Period of validity:
Ongoing
Approval date:
September 2024
Last modified date:
September 2024
Keywords:
Emotional distress, children and young people, mental health, GP, psychological assessment, risk management
Contextual description:
This document provides guidelines for general practitioners on assessing and managing emotional distress in children and young people, including risk assessment, mental health screening, and referral pathways.
Year:
2023
Region / City:
Penn Yan, NY
Topic:
Mental Health Services, Housing Assistance
Document Type:
Referral Form
Organization:
Yates County Adult SPOA
Author:
Yates County Mental Health Services
Target Audience:
Health and social service providers, individuals with mental health concerns
Effective Period:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Contextual Description:
A referral form for supportive housing, ACT services, and non-Medicaid care management for individuals with mental health diagnoses in Yates County.
Year:
2023
Region / City:
North Central London
Topic:
Healthcare Referral Form
Document Type:
Referral Form
Organization / Institution:
North Central London
Author:
N/A
Target Audience:
Healthcare professionals
Period of Validity:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Year:
2020
Region / City:
United States
Theme:
Emergency Housing Assistance, COVID-19 Response
Document Type:
Referral Form
Author:
SSVF
Target Audience:
Veterans, SSVF Grantees, Community Stakeholders
Action Period:
During COVID-19 Pandemic
Approval Date:
N/A
Date of Changes:
N/A
Context:
A referral form used for Emergency Housing Assistance under the SSVF program during the COVID-19 crisis, outlining eligibility and procedures for providing temporary housing to at-risk Veterans.
Year:
20XX
Region / City:
Illinois
Topic:
Affordable Housing
Document Type:
Agreement
Organization / Institution:
Illinois Housing Development Authority
Author:
Not specified
Target Audience:
Property Managers, Housing Authorities, Service Providers
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2024
Region / City:
Gwent, Wales
Theme:
Child Safeguarding
Document Type:
Referral Form
Institution / Organization:
Various Local Authorities in Wales
Author:
Not specified
Target Audience:
Professionals involved in child safeguarding
Period of validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2023
Region / City:
Perth, Australia
Topic:
Psychosocial support, Mental health recovery, Social services
Document type:
Referral form
Organization:
Richmind WA
Target Audience:
Individuals experiencing mental health challenges
Period of validity:
6 to 12 months
Date of approval:
Not specified
Date of amendments:
Not specified
Year:
2023
Region / City:
Inner Eastern Melbourne, Outer Eastern Melbourne, Southern Melbourne, Inner Gippsland, Outer Gippsland
Subject:
Early childhood support, National Disability Insurance Scheme
Document type:
Referral form
Organization / Institution:
National Disability Insurance Scheme (NDIS)
Author:
National Disability Insurance Scheme (NDIS)
Target audience:
Families and carers of children with developmental concerns or disabilities under 9 years old
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Subject:
Referral Process for Nursing Home Residents Regarding Return to the Community
Document Type:
Instructional Form
Agency:
Department of Health Services (DHS)
Author:
Division of Quality of Assurance
Target Audience:
Skilled Nursing Facility (SNF) Staff
Period of Validity:
Not Specified
Approval Date:
Not Specified
Modification Date:
Not Specified