If you are in the process of completing a CAF or have a recently completed CAF in your records please attach a copy to this form. Where a CAF is attached the referral form indicates where duplication of information can be avoided.

You may not be able to complete all sections of the form; however it is very important that full details of names, dates of birth, addresses and ethnicity are completed. Please indicate who has parental responsibility under the Children Act 1989.

Please be specific about your contact details, especially if you work part-time or work from different locations at different times as this will avoid delay if there is a need to contact you

Please complete Part A of the Inter Agency Referral Initial Decision before sending the whole document to the receiving agency.

On receipt of your referral, agencies should complete Part B, returning a copy to you. They may contact you to clarify the information you have provided.

You may post or fax the completed referral (and accompanying material e.g. CAF) to the relevant agency. Only email if you have the relevant security such as encryption software installed on your computer in order to comply with the data protection act.

Address details and other contact details of the majority of relevant children's services in Dorset may be found on the WORD service directory or telephone 0845 355 2099 or go to Dorset family information service.

If you are making a referral because of child protection concerns, you will need to telephone the relevant Dorset County Council Children and Families (social care) office directorate, following up within 24 hours.

By completing this referral form as comprehensively as possible, you will be helping the social care services to make their decision on further action within the time scales set by the statutory framework for the assessment of children in need. You will also help determine the child's priority level with their child in need eligibility criteria.

Gaining consent

Wherever possible, the permission of parents/carers/children/young people (as appropriate to age and understanding) should have been sought before contacting and before the social care services discuss the referral with any other agency. however, "this should only be done where; such discussion and agreement seeking will not place a child at further risk of significant harm or prejudice enquiries under section 47 of the children act 1989, or a police investigation". Where possible you may wish to fill in the form whilst with the family and obtain their signatures before sending to the relevant social care office.

If parental permission is refused and you consider the child to be at risk of significant harm, the interests of the child must come first and therefore the referral must go ahead. Please ensure that you document the reasons for your actions. If you have commenced a CAF during the course of your involvement with the family, this may be included with the referral.

If you have any difficulties or queries, please do not hesitate to contact your Child Safeguarding advisor within your agency or the relevant Social Care Team.