What is the of parental/carers drug/alcohol use and what has triggered the child’s knowledge referral? Details of Parental/Carer Substance Use Who Substance being used Frequency/Quantity Is this person in Any other info treatment? RISK ASSESSMENT INFO: Any relevant knowledge regarding the young person (i.e behaviour, aggression) Any knowledge of family or significant other that could pose a risk Any knowledge of risks in relation to home visit (i.e visitors to home, pets, paraphernalia etc) details of other agencies/professionals involved of Name Agency Contact details Once complete please return to: E Mail: or if sending via secure e mail account, Post: YPDAS, John Tiernan House, 92 102 Ribble Road, Platt Bridge, Wigan, WN2 5EL – Tel No. 01942 865591
What is the child’s knowledge of parental/carers drug/alcohol use and what has triggered the referral? Details of Parental/Carer Substance Use Who Substance being used Frequency/Quantity Is this person in treatment? Any other info RISK ASSESSMENT INFO: Any relevant knowledge regarding the young person (i.e behaviour, aggression) Any knowledge of family or significant other that could pose a risk Any knowledge of risks in relation to home visit (i.e visitors to home, pets, paraphernalia etc) details of other agencies/professionals involved of Name Agency Contact details Once complete please return to: E Mail: or if sending via secure e mail account, Post: YPDAS, John Tiernan House, 92 – 102 Ribble Road, Platt Bridge, Wigan, WN2 5EL Tel No. 01942 865591
hidden_harm_referral_form.docx