Professionals Referral Form (All Ages)

For IAPT referrals please complete Section 1 and Section 2.

For all other referrals please proceed to Section 2.

Section 1. To be completed for IAPT referrals only
Section 2. To be completed for all referrals
Equality Monitoring
Private and Confidential

Risk Assessment for Referring Agencies   It is requested that all referring agencies complete this section. This will not be primarily used as a basis for accepting or excluding referrals from First Steps’ service, however it will inform our own risk management strategy (should we be able to offer a service).   Please include information based upon your own work with the Client, in addition to any known history. It should be remembered that we are aiming to establish a service that is best suited to the Client and to also best manage any potential risks that others may pose to them, as well as any potential risks they may pose to others. In completing this form, we ask that you involve the Client wherever possible (unless completing this form would, in your opinion, increase the potential risk(s) posed).   The purpose of this form is to receive an assessment of the Client, which is agreed (if possible) with the Client. If the Client has not been involved in the assessment, please indicate the reason for this.

Managing Risk Factors/Safeguarding
Referrer Information

GDPR – Consent from Professionals

First Steps ED (“we”) accept referrals from professionals (“you”) in order to provide access to those who need help to our services (including, but not limited to: face-to-face counselling; video consultations; chatbot digital triage service; group support; befriending; training - including skills for carers and skills for professionals). The information that you provide regarding a third party whom you have referred (“service user”) will be used to contact the service user to facilitate service use.

Throughout their use of our services, we may collect anonymised data for reporting purposes to our commissioning organisations, including Children in Need, Comic Relief, the Big Lottery Fund, NHS Clinical Commissioning Groups, and NHS Mental Health Trusts, College and University Student Services. Referred service users will be made aware of their rights under any contract with us upon contact from us, though it is appropriate for you as an individual to make a service user aware of your intention for a referral.

First Steps ED accepts no liability for misinformation received. Should a false referral or one containing defamatory or otherwise illegal information, we will destroy it immediately, and make good on its duties to report data breaches to the ICO and the subject of the data.

We believe that our GDPR lawful basis for processing such personal data is one of legitimate interest and consent.