Referral and Initial Information Record

Department of Health, Department for Education and Employment, Home Office, UK

WHAT:  Form for recording basic information on the child and family, the services they currently access, and any required referrals for further assessment and/or services.  The form should be used with the accompanying guidance Framework for the Assessment of Children and their Families: Guidance Notes and Glossary for Referral and Initial Information Record, Initial Assessment Record, Core Assessment RecordWHO:  Social and community workers working with, or referring a child and/or caregivers for a service. 

WHERE:  Relevant globally as a template.  It would require some changes in order to fit specific contexts.     

WHY:  This form is useful as a standardized template for recording basic information on the child and his or her family, and for making referrals.  

N.B.  This form is designed to be used with the following resources from the Department of Health, Department for Education and Employment, Home Office,  UK, 2000:

  • Framework for the Assessment of Children in Need and their Families

  • Assessing Children in Need and their Families: Practice Guidance

  • Framework for the Assessment of Children and their Families: Guidance Notes and Glossary for Referral and Initial Information Record, Initial Assessment Record, Core Assessment Record 

  • Initial Assessment Record

  • Core Assessment Record Ages 0-2, 3-4, 5-9, 10-14, 15+

  • Framework for the Assessment of Children in Need and their Families: Family Pack of Questionnaires and Scales

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