Referral Form

** In line with the Child Wellbeing Pathway referrers are asked to provide SEAL with a copy of the single Agency Assessment and Chronology at the point of referral.

This requirement has been agreed with Fife Council and all information will be treated in the strictest confidence.

We will consider a child or young person referred to SEAL where a Child Wellbeing Meeting has been held and 1 or more of the following apply: (please select)
In addition, these criteria apply to all children or young people referred to SEAL: (tick which applies)
Priority will be given to those children/young people who: (tick those that apply)
Type of Referral
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Is the Child or Young person:
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Does the child have any Physical, mental health or Neurodevelopmental disorders, or is awaiting a diagnosis or on the Pathway? If so please give details:
Please outline any safety and risk factors below ( e.g. does the child self harm, have they ever absconded, are they on the child protectioin register, do they use alcohol or vapes etc.?)
Why the child is being referred, what support strategies you have already tried and Whether they recieve any ongoing support from you as the Referrer or from any other service.

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