A Care Leaver is someone who is care-experienced and aged between 18 and 25 years old. The service is available to all young people who are open to Ealing Local Authority’s Leaving Care Team, no matter where they live.

Please use the online form below to make your referral, providing as much detail as possible.

Is your referral a Required

For the purposes of this form, 'care leaver' refers to the person being referred. This may be yourself.

Has the care leaver agreed to this referral? Required
Is the carer leaver happy to be contacted? Required

Referrer details (Professional referral only)

Referred care leaver information

Required
Required
Date of birth Required
Address
Required
Required
Required
Is an interpreter needed?
Required
Required

Please note that this is not an emergency service.

If you have any concerns, please contact the emergency service directly.

If you prefer, you can complete the downloadable version of the referral form here.