DRAMM-MARAC Referral Form

DRAMM-MARAC are regular meetings for the most serious cases of domestic abuse in Kirklees. Professionals making a referral to the DRAMM-MARAC should be aware of the actions that agencies may take as a result of their referral (outlined in the MARAC Information Sharing Protocol available from:

Completed referrals to be sent by secure email to:

Referred by:

Name:
Role/agency:
Contact email:
Telephone:
Would you like to attend the DRAMM when this case is discussed? If so please state which date(s) you are available to attend the DRAMM (NB: The DRAMM starts 10:00 am Tues-Fri)

Details of Victim and Perpetrator

Victim / Perpetrator
Name
Date of Birth
Relationship to victim
Address
Telephone
Gender
Ethnicity
Disability
LGBT
Substance Misuse
Mental Ill Health
Risk to professionals

Victim Consent to referral

Consent to referral / Yes/No
Justification to override consent / Right to life (Human Rights Act, art. 2 & 3)
Right to be free from torture, of inhuman or degrading treatment (Human Rights Act, art. 2 & 3)
Prevention / detection or crime and/or apprehension or prosecution of offenders (DPA, sch 29)
To protect vital interests of the data subject; serious harm or matter of life or death (DPA, 2 & 3)
Child protection – disclosure to social services or police for the exercise of functions under the children act, where the public interest in safeguarding the child’s welfare overrides the need to keep the information confidential (DPA, sch 2 & 3
Overriding public interest (common law)
For the administration of justice (DPA, sch 2 & 3)
For the exercise of functions conferred on any person by or under any enactment (DPA, sch 2 & 3)
Has the victim placed any conditions/limitations on their consent (i.e. does not wish to report to police)

Details of children

This includes all children linked to either the victim or the perpetrator.

Children
(inc unborn) / DOB/EDD / Relationship to victim / Relationship to perpetrator / Present: / In the care of/ Address

Reason for Referral

Reason for Referral: / Please choose from the following: / Comment:
Visible high risk (14+ on DASH) / □
Professional judgement / □
Repeat with last 12 months / □
Date of incident/ disclosure
Information/ incident that promoted risk assessment
Relevant history
Please advise if any crimes have been reported to police (either by the victim or yourself). If so, please include the crime log.
Are you aware of any other professionals that are working with the victim/children/perpetrator?
Please advise of any actions that have been taken to safeguard the victim
Please advise of any actions that have been taken to safeguard the children
Please advise of any further information/comment/specific actions that you would like the DRAMM-MARAC to take

If you have any queries regarding this agenda or the MARAC Process, please contact the MARAC team on

01924 431492 or 07977 986744 or by secure email to