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CHUMS referral form for parents/carers

You have now entered the referral form for parents and carers.

CHUMS has multiple services that parents and carers can refer to. These services vary in what they offer and which area of the country they serve – please check the individual service’s criteria on the website for more details.

This form is used for several services so please ensure you select the correct form below.

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 and tailor the answers to the service you are referring to e.g.:

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?

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.

**Please be aware that CHUMS provides commissioned, charitably and privately funded support** If you would like to support the charitably funded services, you can donate here:

https://chums.enthuse.com/chumscharity#!/

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Risk
Are you aware of any risks?
(e.g. behaviours that are a risk to themselves/others such as self-harm, suicidal ideation, substance use and information about if you believe them to be at risk from others)
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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