Making a referral 

You can submit a referral to us in the following ways:

  • By completing this form. 
  • By booking a consulting slot with our Single Point of Access team by calling 01670 502700
  • Via consultation forums ie. Early Intervention Hub, Youth Offending Team (YOT), SORTED or completing a MARF.
  • We welcome referrals from any source, including self-referrals in line with our referral criteria. 

Referral criteria 

To ensure your referral meets CYPS Referral criteria (or is appropriate for CYPS) please use the checklist below (before sending your referral to us)

  1. Are they registered with a Northumberland GP
  2. Is the child/young person aged between 4 – 18 years            
  3. Has the child/young person (or the person with parental responsibility) given informed consent for the referral to be made         
  4. Have you seen the child and undertaken an assessment of need prior to completing the referral. This will help us to prioritise cases. (for professionals only) or (this is not necessary for self-referrals)        
  5. Is the child/young person presenting with (significant degree of) psychological distress or a mental health difficulty that has not responded to previous/first line/primary emotional/mental health interventions. You must enclose detailed information about what interventions have been undertaken and the outcomes  
  6. Have you identified any significant risk (please enclose plan/advice given)
  7. Has all the essential referral information been completed.   

 

 

Required

Referrer details

Required
Address Required
Required
Required
Has the child / young person been seen by you as a referrer? (Please note: Referral will not be accepted if the child / young person has not been seen by referrer) Required

Young person's details

Required
Required
Required
Address Required
Required
Required

Consent for this referral (please tick the boxes below)

Has the young person given consent?
Has the parent given consent?
Consent to contact Education provider for further information?
Our duty team will review this referral, however, if they feel the referral is more appropriate for another service, does the young person/parent/carer give consent to us passing this referral to them?

Parental responsibility held by:

Required
Address (if different from above)

Other agencies currently involved, or with significant past involvements

Address
Address

Reason for referral

Background / Family History / Social Circumstances

Please note: The referral will not be accepted unless this section is completed. If you feel this referral is urgent, please contact our Duty Team for discussion. 

Required
Required
Does the Child / Young Person have any of the special circumstances listed below? Please tick all that apply
Required

Identified Risks

Child Protection Plan Required

Thank you for completing this form. If you wish to discuss this referral prior to sending it to the service, please contact us. Telephone: 01670 502 700 and speak with a member of our team who will be happy to answer any queries you may have.

 

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