Adult Social Care Referral Form for professionals, family and friends

If you are worried about abuse or neglect, please complete the safeguarding referral in the first instance.

To ensure the person receives the best possible support that is coordinated and joined-up, we may share or obtain information with wider partners and organisations, or via the GM Integrated Shared Care Record.
This may include health service providers such as GPs, community health teams, and organisations that offer support, like care providers or equipment suppliers (e.g. Ableworld).

Sharing this information helps ensure the person gets access to the right kind of support and coordinated care.

Full details about how data may be used can be found in the Adult Social Care Privacy Notice (opens in a new window) on the Council’s website.

Security time out

For security reasons, you will have 25 minutes to complete each page of this form. After this time, any information entered will not be saved.

We recommend that you gather any information you may need before you start.

During the form, we will ask you for:

  • any previous contact the person has had with Adult Social Care or other services
  • any medical conditions, disabilities, or health issues we should be aware of
  • any changes that have led to this request for support
  • what you hope our support will help the person achieve