Adult Protection Referral (AP1)

This form should be used by Agencies / Professional staff to submit an Adult Protection Referral

If your referral is urgent please phone Health and Social Care Connect on 0141 287 0555. Please be aware that the response time for online referrals can be up to 72 hours.
If out with normal working hours or at the weekend and you require support you can also contact Glasgow and Partners Emergency Social Work Service on 0300 3431505. This includes referrals for Adult Protection concerns.

If immediate help is required in an emergency situation then phone 999
Fair Processing Notice
To find out how we will process and use your personal information in connection with this request please see our Privacy Statement.
Adult at Risk Details
1. First Name*
2. Second Name*
3. Date of Birth / Age*
4. Flat Position (if relevant)
5. Home Address*
6. Postcode*
7. Phone Number*
8. Current Location (if currently not living at their home address)
9. Postcode of current location
10. Phone Number at current location
11. Gender
12. Ethnic Origin
13. Communication Needs (please provide details including communication aids and specify first language if not English)
14. GPs Name
15. GPs Address

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