Adult Services (North) Referral Form

Only complete the below referral form if you are a social worker or professional working in a PAC-UK subscribing local authority (see below list) and have obtained consent from the data subject/s you are referring. Non-subscribing local authorities must contact the PAC-UK Advice Line (0300 1800 090) prior to completing this referral form. If you are making a One Adoption referral please click here to be redirected to the correct referral form.

We have partnerships with 77 local authorities stretching from Manchester and York in the north to Haringey and Hertfordshire in the south; and in total more than 100 local authorities benefit from our expertise every year.

If you have any questions prior to completing the form, please contact PAC-UK's Advice Line on 0300 1800 090 or email referrals@pac-uk.org

Please include as much detail as possible on the referral form below. Fields highlighted with a red * symbol are mandatory and must be completed in order for you to submit the form.

Please only submit forms once you have obtained consent from the data subject/s you are referring. 

Once you have pressed submit, your form will automatically be sent to the PAC-UK Advice Line who will respond at the earliest possible opportunity. A notification message will appear on your screen confirming your referral has been received and you will receive a copy of your form via email.

All information processed in relation to your enquiry and/or booking adheres to PAC-UK's Privacy Statement.

Note, failure to provide enough information could result in delays. Please read each question carefully to ensure all contact details provided are correct.