All Wales Prevent Partners Referral Form

Please Note - This form does not replace the requirement for a PPN/MARF if you have any immediate safeguarding concerns


Please complete the form to the best of your knowledge and with as much detail as possible.

This information will be administered by the relevant police force and passed to a local Prevent team. Where possible we aim to give you feedback on your referral, however this is not always possible due to case sensitivities.

All fields with an * must be completed. Please download a copy of this form upon completion as you will not receive an emailed copy.


DESCRIBE CONCERNS - In as much detail as possible, please describe the specific concern(s)
COMPLEX NEEDS - Is there anything in the Individual's life that might be affecting their wellbeing or that might be making them vulnerable in any sense?
OTHER INFORMATION - Please provide any further information that you think may be relevant. Include details of any other agencies or professionals working with the individual.