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Make a children’s referral to Northamptonshire’s Multi-Agency Safeguarding Hub.

If you are a professional and want to tell us about your concerns for a child’s welfare please complete this referral form.

This form is only for professionals. If you are a member of the public please call 0300 126 1000

If you are not sure about the needs of the child or whether you should make a referral you can call us on 0300 126 1000

We know that it is sometimes difficult to decide the appropriate point of intervention. To help you to determine levels of need when making your own assessment, please refer to the Thresholds and Pathways document. Again, if you need advice please call us on 0300 126 1000

Before making a referral you should always get the consent of the parents or carers, except where a child is considered to be at risk of harm and you believe that seeking parental consent may increase this risk.

If you believe that urgent action is needed because, for example, a child is in immediate danger please phone 0300 126 1000. You must follow up your telephone call by completing a referral form.

Please note that there is no option to save this form and come back to it, it must be completed in one go.
All fields marked with an asterisk * are mandatory.

Before completing this referral please can you confirm if you have applied the thresholds in the Thresholds and Pathways document? *
Before completing this referral please can you confirm if you have applied the thresholds in the Thresholds and Pathways document?
 
Before completing this referral please can you confirm if you have considered the thresholds in the Thresholds and Pathways document? *
Before completing this referral please can you confirm if you have considered the thresholds in the Thresholds and Pathways document?
Please outline the level of risk you deem this referral to be, based on the vulnerability matrix in the Thresholds and Pathways. *
Please outline the level of risk you deem this referral to be, based on the vulnerability matrix in the Thresholds and Pathways.
Please consider if it is appropriate to make a safeguarding referral based on this level of risk. Needs should be met through engagement with universal services. Key universal services can be accessed through the Children and Families Service Finder
Please consider if it is appropriate to make a safeguarding referral based on this level of risk. If you have not already done so, please complete an Early Help Assessment (EHA) or if you have an existing EHA consider taking through the Complex Case Meeting Process

 
Before completing this referral please can you confirm whether you have a completed an Early Help Assessment (EHA)? *
Before completing this referral please can you confirm whether you have a completed an Early Help Assessment (EHA)?
You can upload a maximum of 5 documents. Please state how many documents you wish to upload. *
You can upload a maximum of 5 documents. Please state how many documents you wish to upload.
 
Do you believe this is a private fostering arrangement?
(i.e. if a child under the age of 16 years old (18 years old if disabled), is being cared for by someone who is not a parent or close relative.) *
Do you believe this is a private fostering arrangement?
(i.e. if a child under the age of 16 years old (18 years old if disabled), is being cared for by someone who is not a parent or close relative.)

Referral Information:


  • Please include ALL relevant information (including info share on telephone) and complete ALL sections, unless doing so might place the child at risk of significant harm.
  • If you don't know, please say so.
  • Please complete the form as fully as possible to enable the Multi Agency Safeguarding Hub (MASH) staff to make informed decisions regarding the next course of action.
  • The form could be returned to referrer if insufficient information is provided.
  • The referral will become an integral part of any Initial Assessment (which should take up to 10 working days)

If the concern needs an urgent response, or if you need advice, a telephone referral should be made in the first instance (0300 126 1000) and this form sent as confirmation.
Telephone ref made? *
Telephone ref made?
Date & time *
Date & time

Form completed by

Address
Are you a designated person? *
Are you a designated person?
We may need to speak with you about this referral. Please ensure the contact number you provide is accessible.
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