Referral Form

This form must be used by professionals and practitioners such as social workers who wish to refer children, young people and vulnerable adults or their carers to NYAS for the provision of Advocacy, IV, IMHA and Independent Return Interview/Return from Missing services.

No referrals will be accepted unless there is a minimum of 5 working days’ notice prior to any meeting in which NYAS services are required.

Please note that all referrals must be made with the service user’s consent with the exception of referrals for non-instructed advocacy.

This is a confidential service as long as the child, young person or vulnerable adult/ carer is safe. If a safeguarding issue is identified by the Helpline confidentiality may be broken as part of our Safeguarding policy.

Please check that all details are correct before submitting the form and ensure that all key information is complete and accurate in particular contact details such as names, telephone numbers, addresses, dates and times

This system of referral has a high level of information security….  All information entered onto this form and sent to us, is done so through a secure server connection using the Secure Sockets Layer (SSL) protocol. This allows your browser to encode any data it sends to our server, so that even if someone intercepted your information as it travelled across the Internet they wouldn’t be able to read it.

If you would like more information you can read up on SSL here – http://www.digicert.com/ssl.htm

All referrals received will be confirmed by the Helpline at which time you may be asked to confirm details or provide additional information.