Make a professional referral to Kingston adult social care

Make a professional referral to Kingston adult social care

You can refer to Kingston Council’s adult social care service as a professional. This includes social workers, doctors, nurses, housing officers, police officers or other professionals who work with vulnerable adults.
Use this form if you're a professional to refer a client for:
- Care Act assessment
- Occupational Therapy assessment
- both
Use the mental health Care Act assessment form if their support needs are predominantly because of their mental health or for Section 117 referral
Before you begin

This form has 6 pages and will take around 10 minutes to complete.
Do not use this form if someone is in immediate danger - dial 999. If someone is being abused or neglected, make a safeguarding concern referral.

You can use this form to create a new referral if you are worried or concerned about an adult who needs support to:
- wash, dress or access and use the toilet
- stay safe around the home, including equipment and alarms
- access the community, leisure or work
- maintain relationships
Try to speak to the person to make sure they want help from us. We may not be able to help someone who does not want it.

Privacy notice

Read our adult social care privacy notice and data protection for information about how we process your data.
Check the box if you are happy to proceed.*

I have read and accept the privacy notice

Type of referral
What kind of referral do you want to make?*

Care needs assessmentOccupational therapy (OT) assessmentBoth

What they need
Are you making a referral for physiotherapy?*

YesNo
We cannot help with physiotherapy. These needs must be referred to the person’s GP.
Are you making a referral for walking aids, wheelchairs or mobility scooters?*

YesNo
We cannot provide walking aids. These needs must be referred to the person’s GP.
Are you making a referral for pressure care? (Like a mattress or cushions)*

YesNo
We cannot help with pressure care. These needs must be referred to the district nurse.
Are you making a referral for hand therapy?*

YesNo
We cannot help with hand therapy. These needs must be referred to the person's GP, who can refer them to NHS Occupational Therapy services.

Details of the person you're referring
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

Town or CityCounty

Postcode
Phone number*
Enter their phone number, for example 020 8547 5000
Email address
If you know their email address, you can add it here
Date of birth*

DayMonthYear
NHS number
This 10 digit number helps us process the referral.
Do they need an interpreter?*

YesNoI don't know
What language do they prefer to use? *
Tell us about anything they use to support their communication

Hearing aid or cochlear implantBritish sign language interpreterBrailleLarge print documentsOther

About you

Thank you for providing information about the person you want to refer. Enter your details so we can contact you if we need more information.
Name*

First NameLast Name
Job title*
Your organisation*
The name of your workplace
Phone number *
This is your work number, for example, 020 8547 5000.
Your email address*
This is your work email address, for example@example.com
Do you have any supporting documents that may help with the referral?*

YesNo
File Upload

Maximum file size 5MB
Cancelof
How would you like us to update you on this referral?

EmailPhoneI do not want to be updated
Should be Empty:

Before you begin