Kinship Carer Self-Referral Form

What Local Authority area do you live in?

Choose a programme

All one-to-one support referrals for Kinship Connected Rhondda Cynon Taf have been received at this time. However, you can still access support from our Advice Service using this form. If you require further information, please get in touch with your Kinship contact or email kinshipconnected@kinship.org.uk.

Your information

First Name

Last name

Telephone

Mobile

Address Line 1

Country

Postcode

Date of Birth (Please capture in this format 19/02/1965 with the relevant date)

What do you most need support with?

What else might you need support with?

How many kinship children are in your care?

How long has the child or children been in your care (in years)?

Do you have a special guardianship order?

Is there an Order in place?

What is your preferred method of contact?

Is there anything else about your situation that you think we might need to be aware of?

I would like to join the Kinship Carers Community. (If you tick 'yes', you'll receive updates around events, advice, useful organisations and other relevant information about Kinsip Carers.)

This form is being filled out by a Kinship Staff member

Do you have permission to share details of the kinship carer for the Kinship Connected programme?

Reason for referral:

Please tell us the primary reason for the referral

If "other", please specify:

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For further details you can view our privacy policy at

https://kinship.org.uk/privacy/

Please tick the box here to confirm you agree with our Privacy Statement.

I agree to the Privacy Statement

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Please allow 5 working days to update your details.

Contact Information