Get Referral Form - Rotherham Rise

This guide provides a clear, step-by-step approach to completing the Referral Form for Rotherham Rise online. Users will learn how to effectively navigate each section of the form, ensuring all necessary information is accurately submitted.

Follow the steps to successfully complete the referral form.

1. Press the ‘Get Form’ button to access the referral form and open it in your chosen editing tool.
2. Begin by filling out the Referral Information section. This includes the date, your agency name, your name as the referrer, as well as your phone number and email.
3. Indicate the service area required by selecting from the options provided, such as 'Domestic Abuse: 1-1 Support' or 'Counselling'. Be sure to choose all relevant services.
4. Proceed to the Client Information section. Enter the client's full name, any names they also use (AKA), date of birth, age, and gender identity.
5. If the client is under 16 years old, fill in the details of their legal guardian, including their name and relationship to the child. Include the client's address and the legal guardian's contact number.
6. Provide details regarding the address safety. Specify if the address is safe to write to, and complete the tenancy type if applicable, alongside any alternative address information.
7. Supply information related to contact methods, indicating if the telephone number and email address are safe to use. Include additional safety measures such as a safe time to call.
8. Complete fields regarding the client's ethnicity, religion, and any significant social or health information, including any relevant employment status and language capabilities.
9. Describe any significant concerns pertaining to the client's safety or wellbeing, and provide information on any alleged perpetrators if applicable.
10. For children associated with the client, fill in their details as requested, noting living arrangements and any involvement from child services.
11. Lastly, ensure the written and verbal consent sections are completed, securing permissions to contact support agencies if necessary.
12. Save your changes, and utilize options to download, print, or share the form as needed.

Begin filling out the Referral Form - Rotherham Rise online today to ensure the necessary support is accessed.