If this concern is not deemed to be immediate you will be asked to fill in this form.
Complete this form by clicking the ‘start now’ button.
Use this form if you have a concern about a child or want to enquire about help and support.
In order for this form to be processed it must be completed in full and consent must be provided (only if a child would be put at risk can a form be submitted without consent).
This form is not for members of the public.
It is important that you check for an existing Early Help Assessment prior to completing a Worried About a Child Form unless this is not possible as you are making the referral out of office hours. Providing Early Help to a child is a shared responsibility and families should be offered Early Help support in the first instance where appropriate. Please call 01709 334905.