9. Consent to request support from other organisations This is consent to make a request of support to another organisations. It is the practitioner’s responsibility to ensure you email this EHA to the required service and the the email address for the required service will appear below when you choose a service from the drop down menu. I, [professional name and role] have discussed the completed Early Help Assessment with the young person [name or delete if not discussed] on [date and time] at [location of discussion], and I am confident that this is an accurate assessment of their needs. The [young person] has consented to a request of support to the following agencies and understands that these agencies may also share the information with additional relevant agencies. Is this a up’ request? Yes No Is this a down’ request Yes No ‘step ‘step If you are making a tier 4 safeguarding request and have been unable to gain consent, or have assessed it unsafe to gain consent, please tick here. Name of child/young Forwarded to service Selection 1 person this relates to Forwarded to Name of child/young Selection 2 person this relates to service Name of child/young Forwarded to Selection 3 person this relates to service Name of child/young Forwarded to Selection 4 person this relates to service Name of child/young Forwarded to Selection 5 person this relates to service
9. Consent to request support from other organisations This is consent to make a request of support to another organisations. It is the practitioner’s responsibility to ensure you email this EHA to the required service and the the email address for the required service will appear below when you choose a service from the drop down menu. I, [professional name and role] have discussed the completed Early Help Assessment with the young person [name or delete if not discussed] on [date and time] at [location of discussion], and I am confident that this is an accurate assessment of their needs. The [young person] has consented to a request of support to the following agencies and understands that these agencies may also share the information with additional relevant agencies. Is this a ‘step up’ request? Yes No Is this a ‘step down’ request Yes No If you are making a tier 4 safeguarding request and have been unable to gain consent, or have assessed it unsafe to gain consent, please tick here. Selection 1 Name of child/young person this relates to Forwarded to service Selection 2 Name of child/young person this relates to Forwarded to service Selection 3 Name of child/young person this relates to Forwarded to service Selection 4 Name of child/young person this relates to Forwarded to service Selection 5 Name of child/young person this relates to Forwarded to service
Young-Person-led-EHA.-4.0.docx