• Personal Budgets, Pan-London Boroughs Referral

  • Criteria

    All referrals must be made by an NHS duty of care/clinician.

    It’s important to us that the client chooses our service therefore please ensure they have seen our virtual tour here and want to be a member and to engage in their creative learning and personal development.

  • Section 1. Prospective member details

  • Please fill in all sections of this referral in order for us to assess for eligibility.

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Tour/Visit
     - -
    2 digit month, 2 digit day, 4 digit year

  • Section 2. Referral team/Care team information

  • Section 3. Client clinical details

  • Accessibility and disability notes

  • Please attach any relevant document (CPA, CAA, case summary) & risk assessment to the application (Please select which documents you are providing and use the File upload below)

  • Relevant documents & risk assessment

  • Browse Files
    Cancelof
  • Is the client under Section 117?*

  • Section 4. Membership goals, options and details

  • Costs for Core Arts are £55 per week for one session or £95 weekly for two sessions. Funding is usually agreed as part of the client's Personal Budget.

    Please call if you have any questions about the funding, otherwise we can confirm details via email once this referral is submitted.

  • Please specify access amount (package type)*
  • Have you secured funding for this membership*

  • Please attach the invoicing details* and/or payment plan (service request form).

    *Please be aware membership cannot be offered unless finance arrangement has been send and set up by brokerage.

  • Browse Files
    Cancelof

  • Section 5. Terms and Conditions

  • As part of the partnership it is required that as care coordinator (or referrer) to feedback on a 3 - 6 monthly basis your professional opinion regarding members progress and our service impact. This is a stipulation of the funded contract and an outcome measurement.

     

  • To be read and signed by the referrer.

    I have informed other relevant clinics or practitioners about this referral and recorded this information on RIO to ensure Core Arts membership is known within the care plan for this individual.

    I agree that as part of this referral I have organised the funding for this membership and understand that a start date will only be offered when Core Arts have received confirmation that the finance is in place for Core Arts to charge and be in receipt of payment for the membership for this client. I understand Core Arts will contact me directly with issues to resolve and I will liaise with fund holders to ensure payment.

    I understand Core Arts will charge termly/quarterly for the membership and will contact me with issues regarding client attendance in order to ensure the funding in place is appropriate.

    If my client is using direct payments I will support the set up of this mechanism and regularly review the set up to ensure support is place if issues arise.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: