Children and young people ; Child to parent violence and abuse: Parents and Young People - Merseyside Domestic Violence Service [MDVS] 0151 709 8770

Children and Young People:

Child to Parent Violence and Abuse;
Parents and Young People

Our Children and Young People's Service is undergoing a review and referrals to the service are temporarily suspended. We will announce on our website and to all our partners when we are ready to relaunch.

You are welcome to contact us for advice or signposting to other services in the interim period thank you for your patience.

For more information please email info@mdvs.org call 07802 722703

Are you a professional referring someone?

Professional Referrals

What service are you referring to?

Child to parent violence and abuse (Parents and Young People) Child or young person for another reason

Referrer Details

Please enter your details below so we can contact you about this if necessary

Referrer Name

Name of organisation

Your phone number

Your email

Younger Person's Details

Please enter information about the young person you are booking below.

Young Person's First Name

Young Person's Last Name

Young Person's Gender

Young Person's Date of Birth

Young Person's Address

Post Code

Is English the Person's first language?

Does the Young Person have any access or communication difficulties we need to be aware of? If so please describe:

Please briefly describe what the young person requires support with and any other information you feel is relevant (including risk and safeguarding information)

Incident Details

Please provide a brief description of the incidents or concerns that have led to this referral:

Risk Assessment

Is there an immediate risk of harm to the parent/carer or young person? If yes, please provide details: Please indicate the level of risk using the following scale

Low Medium High

Contact Safety

Is it safe to contact/call/email/leave a message?

Additional Information

Is the person involved in any of the following?

Parent/Carer

In order to process this referral, we will need additional details to ensure we can work in a safe way with all those involved. If you're referring an adult, please provide please provide information on the child's parent/guardian.

Is the other party aware of the referral?

Yes No

Who is the additional party?

Other party First Name

Other party Last Name

Address

Street Address

Address Line 2

City

Postcode

Other party Date of Birth

Other Party's Gender

Other Party Email

Other Party Phone Number

Are there any other contact details we need to be aware of? (i.e. any additional agencies involved in this case e.g. school, social services ,support agencies )

Your Safety is our main concern

In an emergency please dial 999,
the Police are there to help you.

For assistance

Call, text or email