Rebuilding Families Group Form

Rebuilding Families - Support Form

Join Our Volunteer Support Group - Ask for more information!
Rebuilding Families Support Requirements

In order to provide you the most appropriate support, its crucial that we fully understand what stage you are at with your investigation. Our service is to provide individuals support in order to rebuild their lives and offer tools in order to build those coping strategies, and share each other's journey once the process has ended. For example: We CANNOT provide resources and contacts whilst you are in a ACTIVE investigation with Social Services, NHS, Police etc. Even, if you feel that you are being wrongfully judged. Rebuilding Families have a duty of care to protect and respect the importance of every professional role to protect the community. However, PLEASE don’t be afraid to reach out with a 'General Query', we can offer a lending ear at the very least and maybe point you in the right direction for further guidance.
Customer Details:
Full Name (If you wish to share your pronouns, include them in your contact information (e.g., "Jordan Smith (he/him)")

First NameLast Name
Date of Birth
To join support group you must be over 18 years old
Address (only for data purposes to geographically area of families impacted)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Only required if you wish to use text or phone call support Format: (000) 000-0000.
E-mail
example@example.com
How many children do you have?
Please include any step children , foster or adopted children
Have you fostered or adopted any of your current children (this gives us an understanding of the additional supportive network you would have around you)
Do you class yourself as vulnerable?
The term ‘vulnerable adult’ has been amended as it was felt to be inappropriate to label an adult as vulnerable solely due to their circumstances, age or disability. In general terms, an adult (a person aged 18 or over) is classed as vulnerable when they are receiving one of the following services: • Health care; • Relevant personal care; • Social care work; • Assistance in relation to general household matters by reason of age, illness or disability; • Relevant assistance in the conduct of their own affairs; or • Conveying (due to age, illness or disability in prescribed circumstances)
Our any of the family members classed as having a disability ie mental illness, neurodiverse, learning difficulties or physical illness
Please include parents
Services involved and give a brief description of allegations
Any information shared within this field will NOT be shared with any services reported and will be handled professionally and not shared with other memebers of the group.
What stage are you at with your investigation

Other
If you state 'other' please give details
so we can get a greater understanding of your situation and who with
What’s your account on what happened
Give as much details you can
Reasons for why you feel these professional services have made a mistake
Do you have proof ie physical evidence, medical reports, support from education etc
How did you hear about us?
Please Specify
If you selected other
How can we support you?

Other
If ‘Other’ please explain
Please provide evidence that investigation is now closed or NFA (no further action)

Please DONOT provide any private and confidental records of your case. Just a professional headed letter stating your case is now closed
Cancelof
Additional information
Anything you may feel will be of interest to us, to help support your case?
Signature

Important Disclaimer: you have given consent for Facilitator to review your case, contact you on details provided.
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Rebuilding Families - Support Form

Rebuilding Families Support Requirements