Referral

We provide a warm, supportive home where young people aged 12–17 can feel safe, valued, and empowered to achieve their full potential.

Who We Are

Whether you are a local authority representative, social worker or family member, our team is here to answer your questions and discuss the young person’s individual needs.

Your Details

Full Name *

Organisation or Local Authority

Your Relationship to the Young Person *

Email Address *

Telephone Number *

Young Person’s Details

Young Person’s Name

Young Person’s Age *

Current Location or Local Authority

Is Accommodation Required? *

Preferred Location

Support Requirements

Please select any areas of support required
Emotional and wellbeing supportEducation and trainingIndependent living skillsFamily relationshipsPositive behaviour supportCommunity engagementHealth supportOther

Please provide a brief overview of the young person’s circumstances and support needs *

Are there any immediate safeguarding concerns or known risks? *

If applicable, please provide further information

How Can We Help?

What would you like to discuss with Casa Nueva Group? *

Preferred Method of Contact *

Best Time to Contact You

[acceptance* privacy-consent] I confirm that the information provided is accurate to the best of my knowledge and that I am authorised to submit this referral enquiry.

[acceptance* contact-consent] I consent to Casa Nueva Group contacting me to discuss this enquiry and understand that my information will be handled in accordance with its Privacy Policy.

This form is for referral enquiries and placement discussions. If a young person is in immediate danger, please contact the emergency services or the appropriate safeguarding authority.

Our Values