Prevent Referral Form


  • Radicalisation is a path that can lead a person to support terrorism and extreme ideas that are linked with violent terrorist groups. The person is often groomed to believe that using violence to support their ideas is the right thing to do.
  • Extremist ideologies tend to be exaggerated grievance narratives concerning identity, race, politics, history, sociology and/or religion, often woven together with elaborate conspiracy theories.
  • Does the individual have any vulnerabilities? Some examples of changes in a person’s character may include Emotional Changes – crying, withdrawn, angry and depressed. Verbal Changes – scripted speech, argumentative and inappropriate language. Physical and circumstantial changes – change of clothing, tattoos, new friends, increased internet use and isolation.


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.


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.