HEALTHCARE PROFESSIONAL REFERRAL FORM 2023
PLEASE READ THIS GUIDANCE BEFORE COMPLETING THE FORM:
Please refer to our camper criteria below.
Essential Criteria for Residential Camps:
We invite applications from children ages 8 to 17 years, living in the the UK, who are currently receiving treatment, or experiencing the challenges of a health challenge.
To ensure the child is able to benefit fully from our camp programme, they must :
- Have the physical ability to participate in an action-packed activity programme with a range of high and low energy activities
- Have the social and emotional ability to participate in a group setting and team activities with children of their own age
- Be able to communicate their needs independently
- If they are a wheelchair user, they should be able to transfer from floor to chair and bed to chair independently
- Be able to attend to their own personal cares
Unfortunately, we are unable to accept campers who:
- Have learning, behavioural or social communication needs that would prevent them from participating in age appropriate group activities.
- Are more than 3 years off treatment, if they do not have any ongoing health challenges
- Need planned overnight care/intervention/monitoring, or health care needs that require constant one to one support
- Have Cystic Fibrosis or Primary Ciliary Dyskinesia (due to the risk of cross-infection and infection to immunocompromised campers)
- Are on a ketogenic diet or a low protein diet
- Who require significant assistance with toileting/bathing
-Who require frequent rest periods/naps during the day
Essential Criteria for Camp in the Cloud (Virtual Camp Programme):
- For family camps children aged from birth to 17 years can attend and one child in the family must be aged between 6 to 17 years.
- Camp in the Cloud has a variety of activities including some arts and crafts which wll require the use of scissors and fine motor skills and for some children and young people assistance may be required from an adult in the house.
- Unfortunately we are unable to take campers who are currently a hospital inpatient.
If you have any questions or concerns regarding the applicant or process, please contact us on 02392 477110 option 1 or firstname.lastname@example.org. This form can be returned by email or post, please see the end of the form for details.