One Adoption Referral Form

Only complete the below referral form if you are a social worker or professional working in One Adoption North & Humber, One Adoption West Yorkshire or Barnsley, Doncaster, North Lincolnshire, Rotherham or Sheffield.

If you have any questions prior to completing the form, please contact PAC-UK's Advice Line on 0113 230 2100 or email

PAC-UK will be the lead provider in a service (funded by One Adoption) working with 15 Local Authorities to provide support to anyone in the region affected by adoption.

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 the PAC-UK Advice Line who will respond at the earliest possible opportunity. A notification message will appear on your screen confirming your referral has been received.

All information processed in relation to your enquiry and/or booking adheres to PAC-UK's Privacy Policy.

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

Referring Local Authority /Agency


Referring Social Worker /Professional

  • Address of Local Authority /Agency


Details of person being referred

  • Address

  • Disability


Name/s of other household members


Details of child/ren


Adoption details of person receiving service (if applicable)


Reasons for referral


Document upload


Verification (for anti-spam)