An image
PLEASE FILL IN THE FORM BELOW TO REQUEST ADVICE AND SUPPORT

REQUEST SUPPORT

Please complete this form, in as much detail as possible, to share your concerns and one of our Advisers will be in touch as soon as possible.

Support that we may be able to provide might include individual support for families, help preparing for and attending meetings with any agency supporting their child/young person (assessments, reviews, planning meetings, child protection conferences, EHCP reviews, health care planning meetings etc); supporting them to make effective complaints; facilitating meetings between them and professionals to ensure effective communication; helping them through complex procedures, writing letters, putting across their views etc

Parent and Carer Alliance C.I.C. are recipients of funding from the National Lottery Community Fund which can reduce the costs of services that we are able provide to families who live in Gloucestershire, and whose children/young people have additional needs, so please answer our questions as this helps us to know eligibility for this funding, or if we can offer other advice or support.

UNFORTUNATELY FUNDING IS NOT AVAILABLE IF THE FAMILY DO NOT LIVE IN GLOUCESTERSHIRE

Once you have submitted this form we will be in touch , with either you and/or the family to explain how we might help as soon as possible.

The initial consultation (by phone or email) will be free and during this discussion, any decisions about ongoing support and any costs that might be involved, will be made in agreement with the family. If you are self-funding advice is charged at up to £40 per hour.

By completing this form you are not committing the family in any way, you are just helping us to understand how best to help.

Please tell us who is making this referral
Please tell us a number that we can contact you on

Permission to share Family's information

Please ensure that you have the consent of the family to share this information with the Parent and Carer Alliance C.I.C. before proceeding any further
Please select one answer
If there is a date soon that you need support for, such as a meeting or case conference please tell us here
Please tell us where the family live, as we may have funding to provide reduced cost services

Please give some details of your concerns

Please tell us about why you would like/ the family needs advice and support and we will arrange for someone with the relevant skills to get in touch with you and find out more.

It would be useful to know what additional needs the child/young person has, what service(s) (e.g. education, social care etc.) are of concern and the type of issues that there are - failure to discuss/assess needs, failure to provide agreed needs, etc.
Please highlight all that apply, hold down the control key and click to select.
If you selected Other please give a brief description of these needs
Please summarise your concerns so we can select the best adviser to help
Knowing who is involved in causing you concern can help us advise you
Please summarise their experiences
Please tell us how we could help
Please click on the arrow and select your answer

Agreeing to Give Feedback

The Parent and Carer Alliance C.I.C. is only able to get funding to provide advice and support through Grant funders, such as the National Lottery Community Fund.
For funding to continue to be given, the Alliance needs to demonstrate how the support we provide helps.
We need YOUR HELP and FEEDBACK to do this, as telling us what worked for you, helps funders understand why these services are needed
Please select your answer
Please click on the arrow and select your answer
Please tell us who to contact in the family
Please give the number the family member can be contacted on

Submit

Please click the submit button below to send this form and we'll be in touch very soon. Once the button is clicked a please wait message should appear, then disappear and be replaced by a thank you message at the TOP of the form.

If this doesn't happen, please scroll up for any error messages, as questions with a red star need to be answered for the form to submit. Any issues click here to contact us
AFTER CLICKING SUBMIT SCROLL UP TO CHECK THAT  A 'THANK YOU' MESSAGE APPEARS. YOU WILL BE CONTACTED SOON. 
© 2021 Parent and Carer Alliance