Yuva Surrey

Please be aware that a referral to Yuva cannot be made without the consent of the client.

 Referral guidance:

  • If a young person is under 16, we require a signed consent form from the parent/carer before accepting the referral. See document below.
  • If a young person is over 16, please contact young person for consent and inform parent before accepting the referral. See document below.
  • Before we undertake work with the young person, we ask that the parent/carer engages in an assessment to allow us to obtain an overview of the parent’s perspective, risk and any safeguarding concerns. Parent consultation will be completed with another member of the Yuva team.
  • If a young person does not wish to engage with the service, the parent/carer can access our ‘Who’s in charge?’ parent group and/or five 1-1 telephone support sessions.
  • The referrer will be expected to gain an overview of the young person’s perspective, risk, and any safeguarding concerns.

It is important to advise Yuva if a family is in or will be in court proceedings and at what stage, so that we can discuss expectations around reporting on outcomes with the family.

CLIENT DETAILS

(Please include details of the family member or (ex) partner identified as being affected by young person’s violence/abuse)

YOUNG PERSON USING VIOLENCE

(ex) partner/family member affected (survivor)

Who lives in the household(s)? If the client(s) has children who are not living in the same household please include them below and state who they reside with:

Family Member 2

Family Member 3

Family Member 4

Family Member 5

PROFESSIONALS’ DETAILS

PROFESSIONALS’ DETAILS – 2

PROFESSIONALS’ DETAILS – 3

Please complete consent form below prior to emailing/ submitting referral.

CONSENT TO REFERRAL TO YUVA

I consent to Yuva collecting and storing personal and sensitive data regarding myself or my child’s referral. I understand that this data will be stored securely within the requirements of the Data Protection Act 2018, and that I can apply for access to personal data by submitting a Subject Access Request.

The Yuva Surrey service is operating as part of the Domestic Abuse “Surrey Steps to Change Hub” which requires data being shared with the professional agencies that form this multi-agency service. For more information contact: enquiries@surreystepstochange.com

© Copyright - DVPP West Midlands Design by uMarketeers