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Are you aware of a family who would benefit from this support? If so, please either show them this form or complete it on their behalf, providing that you have the family’s consent.
If you are completing this referral for a young person aged 18 or over, you must have their permission to do so. By submitting this form, you are confirming that they have agreed to this. We will check this with you when we first contact you. If you feel that the young person lacks capacity to grant this permission, we will discuss this with you when we contact you.
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Use of your personal data
I understand that the Information Advice and Support Service (IASS) in Bromley will not use my personal data without my specific consent other than to comply with statutory and legal obligations in relation to safeguarding me or my child or other vulnerable members of my family. Information about how the Information Advice and Support Service uses and protects personal data and about personal data rights is available at www.bromley.gov.uk/privacy