Referral Process for Substance Misuse Worker
Appendix 1
REPORT OF MISSING YOUNG PERSONS FORM[This form is used for any Child/Young Person absent overnight]
NAME : DATE OF BIRTH:
ICS I/D NUMBER:
LOOKED AFTER / CP PLAN LEGAL STATUS:
ADDRESS MISSING FROM :
DATE REPORT RECEIVED IN ECS:
REPORTED BY :
TELEPHONE NUMBER:
REPORTED TO:[person taking the info and their team]
HAVE POLICE BEEN INFORMED? YES / NO / DON’T KNOW
POLICE CAD REFERENCE NUMBER:
NAME OF POLICE OFFICER:
POLICE CONTACT TELEPHONE NO:
DATE AND TIME YOUNG PERSON WENT MISSING:
BRIEF DESCRIPTION OF CIRCUMSTANCES:
ANY UPDATE e.g. IF CHILD IS FOUND / RETURNS
NAME OF SOCIAL WORKER FOR YOUNG PERSON:
TEAM RESPONSIBLE FOR YOUNG PERSON :
TEAM MANAGER :
STRATEGY DISCUSSION/MEETING:
DATE:
DECISIONS:
ADDITIONAL INFO IF THIS IS AN UNACCOMPANIED ASYLUM SEEKING CHILD
ESTIMATED AGE: GENDER: LOOKED AFTER: CP PLAN:
DATE OF ARRIVAL / FIRST REFERRAL:
COUNTRY OF ORIGIN: TN NUMBER: LANGUAGE SPOKEN
ANY KNOWN MEDICAL CONDITION [E.G. DIABETES?]
CONCERN ABOUT TRAFFICKING?
OTHER SAFEGUARDING CONCERNS:
WAS THE LEAFLET ABOUT CHILD TRAFFICKING GIVEN TO THE YOUNG PERSON
Completed form to be sent to .
[It is the responsibility of the allocated worker to make sure that this form is completed as fully as possible. If there is no allocated worker then the team manager must make sure it is completed and sent to the inbox.]
NB Please make sure that the form is renamed to include the name of the child and the date that the form is sent
NB For any child/young person reported missing to the Police, who originated through any of the Airport terminals , please email a copy of this form to the Heathrow Intelligence Unit using one of the following email addresses or
Tel : 02087570708
NB Please also ensure that the form is FAXED to the Borough Police Missing Persons Unit in West Drayton on 0208 246 1703
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