1. 1) Parent/Carer referral  
  2. Completed

CHUMS referral form for parents/carers

You have now entered the referral form for parents and carers. To help us fully understand the problem that you are experiencing please answer all the questions as clearly and fully as you are able to.

If you are having difficulty with any of the questions or would rather speak to someone directly please call 01525 863924 during office hours (9 am to 5 pm).

If you wish to retain a copy of the information you have provided in this referral please use the print option from your browser.

TRAUMA Service referrals

If referring to the Trauma service, please include the following information: what specific event occurred and when/how long ago, what changes have been observed since the event?

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Please note that CHUMS is not an Emergency Service and is not able to respond to this form urgently. Therefore, if there are any immediate risks identified or emergency care required please seek immediate advice from your GP/A&E.

Contact Telephone: 01525 863924

Contact Email: info@chums.uk.com