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Monklands Baby and Family Clothing Aid Project
operated by Diamonds in the Community
Referrering Partner Details
Name
Position
Agency
Agency Address
Email Address
Phone Number
Phone Number
Are you happy for us to store your details for analysis?
Date of Referral Submission
Date of Collection Requested
Name of Person Collecting
Has family been referred to any of the below agencies for help?
Financial Inclusion Team
Welfare Fund
Social Work
CAB
Family Details
Parent Initials
Postcode
No. of People being Referred
Ages
Reason for Referral
Low Income
Temporary Accommodation
Homeless
Domestic Abuse
Single Parent
Young Parent
No Access to Public Funds
Disabled/Family Member disabled
Seeking Asylum
Military Family
Low Income
Other
Person 1
Gender
Age
Shoe Size
Person 2
Gender
Age
Shoe Size
Person 3
Gender
Age
Shoe Size
Person 4
Gender
Age
Shoe Size
Person 5
Gender
Age
Shoe Size
Person 6
Gender
Age
Shoe Size
Baby Equipment and Care Products
We supply a starter pack for new mums which includes a baby bath, clothing, blankets, nappies, bottles and toiletries. Our cots and moses baskets are supplied with new mattresses. We also supply for the following items.
Baby Equipment
Starter Pack
Moses Basket
Cot
Cot Bed
Pram
Buggy
Bouncer
Bath
High Chair
Potty
Bottles
Steriliser
Play Gym
Toys
Nappies
Newborn
Size 1
Size 2
Size 3
Size 4
Size 4 +
Size 5
Size 5 +
Size 6
Size 6 +
Nappies
Toiletries
Baby wipes
Other
Maternity Pads
Sanitary Pads
Tampons
Breast Pads
Toiletries
Requests/Comments
Miscellaneous Requests/Comments
Comments (To be completed by DITC Member)
Referral Complete by
Date Completed
Collected by
Date Collected
Notes
Otherwise, if you or a family member would like support from The Baby Bank, please get in touch. While we cannot assess your family’s level of need ourselves, we can ask your midwife, social worker or other family support to confirm your referral. Our referral form is secure, we do not need names. If preferred, the professional referring can simply put their own name for collection purposes. We will not pass the details of the family to anyone else; the only information we will ever share is the number of cots, buggies, bundles of clothes etc that we have given out in the past year. We aim to respond to all queries and referrals within 48 hours. If you have any questions or an urgent request, do not hesitate to email us.
Send
Referral Forms
Baby and Family Clothing Aid Referral Form
Go to form
Home Comforts Referral Form
Go to form
In accordance with the current data protection laws, please take a minute to review the term & conditions for using our services. Our terms describe how we use data and the options available to you.
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