Section 47 — HAPii

Referral Submitted

Thank you - your Circuit Court Section 47 Assessment referral has been received by the HAPii team.
We will be in touch within 2 working days to discuss the court direction, scope, documents, and next steps.

Referral Details

Date of Referral *

Preferred Contact Method *

Level of Urgency *

Next Hearing / Filing Date

Referring Person / Organisation

Name *

Position / Role *

Organisation / Agency *

Contact Phone *

Contact Email *

Court & Legal Context

Circuit Court Area / Venue *

Case / Record Number

Court Direction / Terms of Reference *

Parties / Representatives

Child / Young Person Details

Name(s), Date(s) of Birth & Age(s) *

Current Placement / Living Arrangement *

Legal Status / Care Order

Communication, Disability, Cultural or Access Needs

Parents, Carers & Significant Adults

Parent(s) / Guardian(s) *

Current Carer(s) / Key Adults

Siblings / Significant Relationships

Assessment Questions & Welfare Concerns

Reason for Referral *

Current Welfare Concerns *

Specific Questions for HAPii to Address *

Child's Views / Voice / Wishes

Background & Current Arrangements

Relevant History

Current Care / Contact / Access Arrangements

Current Professional Supports

Safeguarding & Risk

Immediate Risk / Safety Concerns? *

Restrictions / Safety Plan in Place?

Risk / Safeguarding Details

Assessment Scope & Practical Arrangements

Preferred Delivery / Meetings *

Location / Proposed Venues

People to Be Interviewed / Observed

Availability / Timing Constraints

Preferred Consultant

Declaration

I confirm I have authority to make this referral and that the court direction, consent, information-sharing permissions, and safeguarding arrangements are in place or will be clarified before assessment begins. I understand HAPii may request further information before confirming scope, availability, and suitability.

Additional Notes

Signature (Full Name) *

Date *

HAPii Circuit Court Section 47 Assessment Form

Referral Submitted