Wandsworth Groupwork Referral Form Please complete this form to refer a Parent to any of the following Groups Strengthening Families Strengthening Communities (SFSC) / Solihull / / Women’s Support (Domestic Abuse) Speak Easy Please also complete this form if you would like to refer a child to the Community Group Programme (CGP) There is a separate referral form for Caring Dads. Please contact Toni Causer if you require this form. All our groups run in term time and are usually delivered in the day with the exception of the Fathers SFSC and Caring Dads which are delivered in the evening. As much information as possible should accompany this form. You are strongly encouraged to talk to the Groupwork Service regarding any family you are considering for group prior to making any referral. You can contact us on 020 8871 8255. The family should be aware that you are referring them to be considered for a parenting group prior to submitting this form. Please send your completed form together with any supporting attachments, electronically to The Groupwork Service Business Suport Officer: Your referral will be processed within 10 working days. Referrer’s details Your Name Referring agency Email: Telephone: Date of referral Your manager’s name: Last contact you had with the family Family’s Details Please complete for ALL Parents / Carers (living together or separated) and ALL Children Name Male / D.O.B Ethnicity Lone Relationship Which Address Female Religion Parent to Group are Contact Number Start with the Parent First- Yes/No Parent/Child you Email Address you are referring language you are Referring (Child if its for CGP) referring too
Wandsworth Groupwork Referral Form Please complete this form to refer a Parent to any of the following Groups Strengthening Families Strengthening Communities (SFSC) / Solihull / Women’s Support (Domestic Abuse) / Speak Easy Please also complete this form if you would like to refer a child to the Community Group Programme (CGP) There is a separate referral form for Caring Dads. Please contact Toni Causer if you require this form. All our groups run in term time and are usually delivered in the day with the exception of the Fathers SFSC and Caring Dads which are delivered in the evening. As much information as possible should accompany this form. You are strongly encouraged to talk to the Groupwork Service regarding any family you are considering for group prior to making any referral. You can contact us on 020 8871 8255. The family should be aware that you are referring them to be considered for a parenting group prior to submitting this form. Please send your completed form together with any supporting attachments, electronically to The Groupwork Service Business Suport Officer: Your referral will be processed within 10 working days. Referrer’s details Your Name Referring agency Email: Telephone: Date of referral Your manager’s name: Last contact you had with the family Family’s Details Please complete for ALL Parents / Carers (living together or separated) and ALL Children Name Start with the Parent you are referring (Child if its for CGP) Male / Female D.O.B Ethnicity Religion First- language Lone Parent Yes/No Relationship to Parent/Child you are referring Which Group are you Referring too Address Contact Number Email Address
groupwork_referral_form.docx