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Baby Feeding Bank Referral

This Referral Form should be filled and submitted by a midwife, health visitor, social worker, or other front-line professional. Referrals are to be collected. Please select a date you or the family referred are able to collect.

Families can be referred when required whilst their baby is under 1 year. 

Referrals closed until 4th September

Baby Feeding Bank Referral Form

Clothing for Child One
Clothing for Child Two
Sleeping
Feeding
Child Hygiene Items
Adult Hygiene
Miscellaneous
Play items
EQUAL OPPORTUNITIES
KidsBank Chester believes that no child, individual, or family should be excluded from the charity’s activities on the grounds of age, gender, health or disability, pregnancy, maternity, sexuality, class, family status, means, ability, colour, ethnic origin, culture, religion, or belief. You are not obliged to fill out the Equal Opportunities section.
CONSENT SECTION
Referrer should please confirm that all information given is accurate to the best of your knowledge, that the family have given consent for this referral, and that you understand delivery will be made direct to the family, unless by alternative arrangement. Please also be aware that anonymised baseline data will be collected for monitoring and evaluation purposes. Please advise parents that they may refer themselves after the first referral but that, at the discretion of the KidsBank Chester Team, after 2-3 self-referrals, the next referral will need to be from a professional.