Referral for support - Professionals

Professional Referrals

If you are working with a child or family in Sheffield who has been affected by domestic abuse, you can make a referral to Haven for support which is voluntary and free of charge.

Please note that we now only accept referrals through the online form below.

To enable us to process a referral, you will need to confirm that consent has been obtained from the parent/carer and they are happy for you to proceed and share their personal information.

Any information that we collect is stored securely and treated confidentially. It will not be shared with any other agency unless we are required to do so by law, or unless any person will come to harm if we do not share it. Haven’s Privacy Policy explains how we protect your personal data and privacy.

Once we have received your referral, we’ll confirm receipt and aim to make contact with the family within 3 working days.

If you need any help completing the form, or have any questions, please call us on 0114 213 0590 or email admin@havenorg.uk

Professional referrer information

Name of Professional Referrer *

First Name

Last Name

Role

Agency you represent *

Office number *

(###)

###

####

Mobile number *

(###)

###

####

Email *

Contacting you

Are you aware of any other agencies working with the family?

Yes

Have you obtained consent from the safe parent/carer/child to make this referral and share personal information? *

If no, please do not provide further information without consent. For further guidance please contact us on 0114 213 0590.

Yes

No

Safe parent/carer information (this is the person we will contact regarding the child.

Name
First Name

Last Name

Address
Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone number
(###)

###

####

Preferred method of contact
Telephone call

Text message

Is it safe for us to contact them by telephone call?
Yes

No

Don't know

Is it safe for us to contact them by text message?
Yes

No

Don't know

Is it safe for us to leave voicemail?
Yes

No

Don't know

Is it safe for us to post a letter?
Yes

No

Don't know

Interpreter

Do they require an interpreter?
Yes

No

Which language is required?

Child/children's details

Please enter their name(s) and date(s) of birth

Do they have a Family Intervention or Social Worker who is currently supporting them?
Yes

No

If yes, do you consent for us to contact them regarding this referral?
Yes

No

Is there anything else you would like to tell us at this stage?

Reason for referral

Please provide a brief description of the reasons for your referral to Haven.

Please give details of the alleged perpetrator, their relationship and their current contact with the child/children.

Is the family currently living in a Women’s Aid Refuge, Safe Zones property (IDAS), SCC dispersed temporary accommodation?
Yes

No

Don't know

Have sanctuary measures been provided by IDAS, (target hardening) e.g. alarms, window locks or other security measures in the property, that the family is currently living in?
Yes

No

Don't know

If yes, please provide details.

Thank you!

Thank you for taking the time to complete this referral form, one of our team will aim to call you within 3 working days of submitting it and to discuss next steps. If you have any questions in the meantime, please call us on 0114 213 0590

Registered Office

Haven
C/O The Circle
33 Rockingham Lane
Sheffield
S1 4FW

Reg Charity No: 1096964
Company Reg No: 4657756

Sitemap | Accessibility | Terms & Conditions | Privacy Policy | Staying Safe Online

QUICK EXIT