Adopt London Referral Form

PAC-UK and Adoptionplus are providing additional dedicated support during the COVID-19 containment period for for adoptive families and for families caring for children under Special Guardianship Orders within Adopt London. This online referral form can be completed by parents or social workers.

The below online referral form can be completed by parents or social workers.

If you have any questions prior to completing the form, please contact our dedicated Adopt London Helpline on 020 7284 5874 (open Monday to Saturday 7.00pm to 9.00pm) or the PAC-UK Advice Line on 020 7284 5879 (open Monday, Tuesday and Friday 10.00am to 4.00pm and Wednesday and Thursday 2.00pm to 7.30pm). You can also email adoptlondon@pac-uk.org to request a call back.

Please include as much detail as possible on the referral form below. Fields highlighted with a red * symbol are mandatory and must be completed in order for you to submit the form.

At the bottom of the form there is a verification code you must enter before pressing submit (this is an anti-spam measure). The verification code can be any two digits of your choice, for example 12.

Once you have pressed submit, your form will automatically be sent to our Adopt London Helpline who will respond at the earliest possible opportunity - we aim to respond to all requests within one working day. A notification message will appear on your screen confirming your referral has been received.

All information processed in relation to your enquiry and/or referral adheres to PAC-UK's Privacy Policy and the data share agreement Adopt London, PAC-UK and Adoptionplus have in place to deliver this service.

Note, failure to provide enough information could result in delays. Please read each question carefully to ensure all contact details provided are correct.

Data subject consent
For social workers completing this form on behalf of data subject/s (families): By completing this form you are confirming you have received consent from the data subject/s for their data to be shared with PAC-UK, who can now make direct contact with the data subject/s. For data subject/s (families) making self-referrals: By completing this form you are confirming you consent for your data to be shared with PAC-UK, who can now make direct contact with you.
Parent/SG 1
ADOPT LONDON EAST: Barking & Dagenham, Havering, Newham, Tower Hamlets. ADOPT LONDON NORTH: Barnet, Camden, Enfield, Hackney, Haringey, Islington. ADOPT LONDON SOUTH: Croydon, Kingston, Lambeth, Lewisham, Merton, Richmond, Southwark, Sutton, Wandsworth. ADOPT LONDON WEST: Brent, Ealing, Hammersmith & Fulham, Hounslow.
Parent/SG 2
If you only wish to be contacted on the primary contact phone number provided in the 'Parent/SG 1' field you do not need to provide an additional phone number.
If you only wish to be contacted on the primary contact phone number provided in the 'Parent/SG 1' field you do not need to provide an additional phone number.
Details of child/ren
Referring Social Worker /Professional (Where Applicable)
ADOPT LONDON EAST: Barking & Dagenham, Havering, Newham, Tower Hamlets. ADOPT LONDON NORTH: Barnet, Camden, Enfield, Hackney, Haringey, Islington. ADOPT LONDON SOUTH: Croydon, Kingston, Lambeth, Lewisham, Merton, Richmond, Southwark, Sutton, Wandsworth. ADOPT LONDON WEST: Brent, Ealing, Hammersmith & Fulham, Hounslow.
Service provision
The service will be provided via video or telephone call. Preferences will be discussed with each parent.
Provide a brief overview of the current family situation.
Please ensure we are advised of any current or previous issues safeguarding issues that are relevant to the practitioner offering the support.
Please list any other information or issues we should be aware of at this stage here. If you would like to send supporting documents with this referral please email these directly to oneadoption@pac-uk.org as soon as you have submitted this referral form.
PAC-UK is required to share all referral data with our contract commissioner (Adopt London) for contract monitoring, reporting, statistical and safeguarding purposes. The data subject/s will be asked to provide additional written consent (via email) before any referral data is forwarded on to Adoptionplus.