Local authority Kinship Connected referral form

Page 1

Questions marked with a red asterisk (*) are mandatory.
Before you submit this referral
Kinship Connected is only available as part of a pilot research trial funded by the Department for Education. Before referring a kinship carer, please make sure you have:
  • explained that Kinship Connected is part of a research programme and that taking part in the evaluation is required to access the programme
  • Shared this easy read information document about the trial: https://kinship.org.uk/kinship-connected-trial-easy-read 
  • explained that places are allocated randomly — this means the kinship carer may start the programme straight away or join a waitlist for 6 months
  • made clear that the waitlist decision is not based on individual circumstances or level of need
  • confirmed that the kinship carer is aware they will be contacted by CEI and Ipsos, the independent evaluation partners, to complete further consent and a short survey
  • explained the inclusion and exclusion criteria (for example this programme is not for foster kinship carers)
  • provided the kinship carer with information about Kinship's other support and services at www.kinship.org.uk, which are available to them regardless of when they start the programme
If you are unsure whether the kinship carer fully understands the above, please take some time to discuss it with them before submitting this referral. 

You can read through the information about the research trial on the Kinship website. Please click on this page: 
https://kinship.org.uk/kinship-connected-research-trial-la-referral/

You can contact us at navigator@kinship.org.uk if you have any questions.
Information you'll need to complete referral

Before you start this referral, please make sure you have the following information available about the kinship carer you are referring:

  • full name of kinship carer
  • full address including postcode
  • contact details (email and phone number)
  • background details about the kinship carer and their circumstances

Please also make sure you have also talked to the kinship carer and told them you are making this referral.


There are 3 sections to this referral form:

  1. your details as the referrer
  2. details of the kinship carer
  3. safeguarding concerns



Consent permissions:


Page 2

Referrer's details:






Family information

Kinship carer information:

This should be their given name as it would appear on official documents.

If the kinship carer has a preferred name, please add it here. For example, if their first name is "Samantha" but they are known as "Sam".



















Safeguarding and support around the family





Please provide details of the risk or concern
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