Make a referral

Criteria

Anyone can make a referral to our services on behalf of a child or young person age 0-18.
We currently only accept referrals for children and young people living in Islington and Camden.
A responsible adult must be able to attend both assessment and intervention sessions with the child or young person.
Individual referral criteria will depend on the healthcare professionals working at the Growing Hope clinic.

Please note that although Growing Hope is founded on Christian belief, we accept referrals for anyone irrespective of their beliefs.

What can I expect?

Please allow one working week for your referral to be processed. If your referral has been successful, you will be sent a confirmation email with a date and time for your child’s assessment. If we have a waiting list in place at the time you make a referral, we will let you know.

Your child or young person will attend an initial assessment. Following this, you will receive a short report detailing your child’s needs and making recommendations for intervention and support, if required. If your child requires intervention, you will be offered a block of six weeks of therapy.

It is essential that you attend both the assessment and therapy with your child as the primary aim of sessions will be to work on goals set between yourself, your child and the therapist. The therapist will explain and teach therapy strategies to the adult who attends the session so that these can be carried out at home.

One-to-one therapy sessions will last around 45 minutes and will include time in which the therapist will ask if there is anything that they can pray for you or your child. It is OK to refuse this prayer if you would like to.

Sometimes one-to-one sessions will not be necessary for your child and they may be invited to a group alongside other children who have similar needs instead.

Referral form

If you would like to make a referral please complete the following form. If you are having difficulties then please contact us and we will be able to request details and process your referral.

Please note that by completing the form or emailing your details, you are consenting to these being stored on a clinic database. The database is encrypted and only ever accessed by trained individuals with a password.

Please select the clinic and professional the referral is for *

Please note if the area you live in is not listed we will not be able to accept the referral. Occupational therapy (OT), Speech and Language therapy (SLT), Physiotherapy (PT).

Child Name *

First

Last

Child DOB *

Parent/Carer Name *

First

Last

Second Parent/Carer name

First

Last

Reasons for referral *

Please briefly describe the reasons for referral. Let us know what everyday tasks your child finds difficult, such as washing, dressing, eating, playing or handwriting

Contact phone number *

Address *

Please write your full address and postcode. Note: you must live in Camden or Islington to access Growing Hope King's Cross

Email contact *

Description of needs *

Please let us know if your child has any known diagnoses (e.g. Autism, Down's Syndrome, Cerebral Palsy)

Would you like any other professionals, such as a teacher or GP, to receive your child's report?

First

Last

Please add the name of the professional, their profession and email address. Please note that if you complete this field you are providing consent for us to contact this professional and pass on your child's information.

Would you like any other professionals, such as a teacher or GP, to receive your child's report?

First

Last

Would you like any other professionals, such as a teacher or GP, to receive your child's report?

First

Last

Would you like any other professionals, such as a teacher or GP, to receive your child's report?

First

Last

I heard about Growing Hope *

CONSENT *

I confirm I am the child's parent/ carer or I have gained consent from the child's parent/carer to complete this referral.
I consent to Growing Hope contacting me in relation to Growing Hope's services and to holding and processing my data on a secure email system and encrypted database.
I would like to hear more about Growing Hope as a charity through their monthly newsletter.

Phone