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Multi-agency referral and assessment form

About this request form
The form is likely to take up to 20 minutes to complete. Once completed, you will have the opportunity to save and download the form, for your reference. You will also receive an email receipt to confirm that it has been submitted.

Before you start, you will need to ensure that you have the family's consent to make the request, the family's details including names. address and dates of birth.

If the referral is the result of poor school attendance, you will also be asked to attach a school attendance report to the request.

You will be required to login or register for an account in order to complete and submit the assessment. Once you are signed in, you will be able to part-fill the form, save and return to complete it later.

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If you are worried that a child or young person is at immediate risk, please contact the assessment and access team immediately on 020 7641 4000.

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