Advocacy Referral

Please Note:

The advocacy service is a confidential service and unable to share information provided by young people unless requested by the young person or a safeguarding concern. The service is transparent and shares all information we hold with the young people we are working for.

Your name*

Your email*

Your contact number*

Before Making This Referral, Please Note:

Referrals can only be made on behalf of young people who have provided full consent for the referral to be made and their personal information to be shared.

Professional relationship to young person*

Young person's name*

Young person's age*

Young person's date of birth*

Young person's contact number*

Additional contact numbers (foster carer/support worker)

Full address of young person*

School details

School contact

Is the young person under social services via:*

Kent
Medway

(Please note we can only accept referrals for Kent or Medway young people)

Legal status of young person*

Is the young person aware of the referral?*

Yes
No

If not, please explain reasons why the young person is not aware of the referral

Has this young person had previous advocacy support via YLF?*

Yes
No
Not sure

What is the issue requiring advocacy support?*

(please provide as much detail as possible)

Are there any safety/risk assessments we need to be aware of?*

Yes
No
Unknown

If yes, please add further information here:

How did you hear about us?*

Background/contextual information that may be useful to the referral:

Please provide details for another person we can contact should you be absent/unavailable:

CAPTCHA

Check to confirm:*

I confirm the young person has provided consent for a referral to be made on their behalf and all information contained within the referral to be shared with the advocacy service.
I understand the advocacy service is a confidential service and unable to share any information provided by young people externally unless requested by the young person or if relating to a safeguarding concern. I understand the service is transparent and will share all information with the young person.