Test Referral

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Form Instructions

If you have a timeout issue
We are currently investigating a timeout issue with the portal which can prevent users from submitting referrals. This is only affecting a few people. If you can't submit a referral then please follow this temporary path:
 
Please contact the Safeguarding Team on Tuesday 11th April on 0300 123 4042. The Safeguarding Team are available between the hours of 09:00 - 17:30 Monday to Thursday and 09:00 - 16:30 on Friday (Excluding Bank Holidays).

If you need an immediate response out of hours, please call 0300 123 4042 and ask for the Safeguarding Out of Hours Team.
What will I need to complete this form?
You will be required to create a portal account, or log in to an existing account, in order to complete and submit the form.

If there is immediate danger to life, risk of injury or if a crime is being committed, dial 999.


This portal is for adult safeguarding referrals ONLY. Please provide as many details as possible about the situation. Please describe:

  • Details of the allegation
  • When and where it happened
  • What type of abuse is suspected
  • Primary support needs
  • If anyone else was involved
  • Details of risks
  • Any actions that have been taken
  • If there are any desired outcomes
  • Do they have capacity

This symbol You will be required to create a portal account, or log in to an existing account, in order to complete and submit the form. If there is immediate danger to life, risk of injury or if a crime is being committed, dial 999. This portal is for adult safeguarding referrals ONLY. Please provide as many details as possible about the situation. Please describe: * Details of the allegation * When and where it happened * What type of abuse is suspected * Primary support needs * If anyone else was involved * Details of risks * Any actions that have been taken * If there are any desired outcomes * Do they have capacity This symbol indicates that the question is mandatory and must be answered in order to continue. image. indicates that the question is mandatory and must be answered in order to continue.
How long will it take?
The form will take 10-15 minutes to complete depending on the amount of information you need to provide. Please be aware that for security reasons your session will timeout after 30 minutes of inactivity.

Please save your form regularly using the 'Save for Later' button at the bottom of the screen. The form will then be available for 90 days in your list of My Saved Forms.
Viewing, printing and saving a copy of the form
Once you have submitted the form you will be able to see a copy in the "Submitted Forms" section of the portal for 90 days; after this the form will no longer be visible from the portal.

Open saved forms
At the top of the screen select the Submitted forms option: Once you have submitted the form you will be able to see a copy in the "Submitted Forms" section of the portal for 90 days; after this the form will no longer be visible from the portal. Open saved forms At the top of the screen select the Submitted forms option: This will give you a list of forms that you have completed and sent to us. Select the one you want, under Details, to open. You can print or save a copy locally. image.

This will give you a list of forms that you have completed and sent to us. Select the one you want, under Details, to open. You can print or save a copy locally.

Once you have submitted the form you will be able to see a copy in the "Submitted Forms" section of the portal for 90 days; after this the form will no longer be visible from the portal. Open saved forms At the top of the screen select the Submitted forms option: This will give you a list of forms that you have completed and sent to us. Select the one you want, under Details, to open. You can print or save a copy locally. image.
How to update the form if Adult Care Services require more information
There may be times that we ask you for more information. We will not progress this referral until you re-submit the form with the extra information.

You will receive an email asking for further information. You can click on the link in the email or go to the Submitted forms section of the portal. The Forms requesting more information section will be at the top.

There may be times that we ask you for more information. We will not progress this referral until you re-submit the form with the extra information. You will receive an email asking for further information. You can click on the link in the email or go to the Submitted forms section of the portal. The Forms requesting more information section will be at the top. The missing information details will be under Comments, including the name of the referred adult. Open the form by clicking on the link on the left under Form. You can update most of the questions (except name, DOB and address) and re-submit it. image.

The missing information details will be under Comments, including the name of the referred adult. Open the form by clicking on the link on the left under Form. You can update most of the questions (except name, DOB and address) and re-submit it.
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