Multi Agency Referral Form


Is this an emergency situation? If so, call 999 for advice.

If you have significant worries, please call the MASH Team to speak to the Duty Social Worker for advice before submitting this form:
  • 0121 788 4300 option 2 (Monday to Thursday 8:45am - 5:20pm, Friday 8:45am - 4.30pm), or
  • 0121 605 6060 (Evenings, weekends or bank holidays)
denotes a mandatory field

Preliminary questions