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Making a professional referral to adult social care

This referral form should be used by GP's, health professionals and multi-agency staff to make a routine referral for:

  • social care
  • home adaptations and equipment

You have the opportunity to share any additional documents that support the referral, for example, photographs, reports and any other relevant actions to date.

Things to consider before making a referral

There are a number of things to consider before making a professional referral to adult social care.

Continuing health care needs

GPs and other health professionals are requested to consider continuing health care needs prior to completing a referral.

Self help

Where possible please signpost to the range of self-help support we offer from our website. These options may support the client whilst their referral is processed or negate the need for a referral to adult care at this time. Useful links are:


Please do not use this form to report safeguarding issues. There is guidance on how to make a safeguarding referral available from the Derbyshire Safeguarding Adults Board.

Emergency out-of-hours support

We provide an emergency out-of-hours countywide social care support from 5pm to 9am Monday to Friday and 24 hours per day at weekends and on bank holidays.

This service is available for the public and agencies to access a range of social care staff for adults or children in need of social care. If you use these numbers in an emergency, there is also the option to speak to an out-of-hours worker, tel: 01629 532600. Routine professional referrals are not accepted by telephone.

If you need support for yourself, or for a family member or friend, please Call Derbyshire:

  • tel: 01629 533190
  • minicom: 01629 533240
  • text: 86555
  • email:
  • write to: Adult Social Care, Derbyshire County Council, County Hall, Matlock DE4 3AG

Making your referral

We attempt to review all referrals within 24 to 48 hours (that is on the next working day). However, this could be up to 72 hours if the referral is submitted late on a Friday, over the weekend or before a bank holiday.

If you require an urgent response during the normal working hours (9am to 5pm, Monday to Friday), please mark as urgent within the referral details, clearly stating when a response is required within 24 hours, where there is an imminent risk of support breakdown.

If you require an urgent (within 24 hours) response out of these hours, please ring Call Derbyshire tel: 01629 533190.

Make a referral

Area contact numbers for making an adult care referral

Amber Valley
Fax: 01773 728111

Fax: 0115 930 3058

Fax: 01246 813197

Fax: 01246 347939

North East Derbyshire
Fax: 01246 865137

High Peak
Mid fax: 01663 747238
South fax: 01629 79367
North fax: 01457 858908

South Derbyshire and South Derbyshire Dales (Ashbourne, Swadlincote, Etwall)
Fax: 01283 819719

Derbyshire Dales North (Matlock, Bakewell)
Fax: 01629 560681