FireSafe Referral

We offer a free Juvenille Firesetter Intervention Programme which works with children and young people who set fires or who play with fire. Without help and guidance, firesetting behaviour can become increasingly serious and lead to injury and damage to property. Early intervention can significantly reduce the chance of this behaviour continuing.

If you are concerned about a child or young person, get in touch with us by filling in the referral form,

FireSafe Referral Form

Date of referral(Required)

Young Persons Details:

Name of Young Person(Required)

First Last

Date of Birth(Required)

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Which school do they attend?(Required)

Please state any SEND/ additional needs that the young person may have.

Has the SEND been diagnosed or awaiting diagnosis?

Please give details of any incidents caused by the fire setter and any other information we need to be made aware of:

Is the fire setting taking place in the home or community?

If so, was there a fire?

Please detail the current incident of fire setting

Has the young person previously been involved in Fire Setting?

If yes please tell us if they have received fire education intervention previously and by which organisation

Does the young person have an arson conviction?

Parent/Guardian Details: Who does the young person live with?

Parent or Guardian Name

First Last

Contact Number

Additional Contact Number(s)

Parent or Guardian Email Address

Referrer Details

Name

First Last

Job title

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Phone

Are any other agencies involved with the fire setter?

Details of other agencies, please provide name, email address and contact number

Please confirm the following:

Confirm that the fire setter and/or parent or guardian have agreed to have their details passed to North Yorkshire Fire & Rescue Service (NYFRS) and that we are able to store their data

Yes

NYFRS may need to work with the child/ young person in school. Please confirm that the parent or guardian have consented to NYFRS contacting the school to arrange to work with the child/young person

Yes

Are there any risks or environmental factors that NYFRS should be aware of before a visit is carried out? If yes, please give further details below.

Yes

Are there any potential risks to the safety of NYFRS staff when visiting the young person in their home or school? This is where the young person or a person in the home is considered to present a legitimate risk (not speculative) to NYFRS staff visiting the property and NYFRS may need to consider additional measures to safeguard their staff.

Yes

Add further details here:

How we use your information:

North Yorkshire Fire and Rescue Service (the Authority) as the data controller will process your information in line with relevant data protection laws. To find out more about how we will use the information you provide on this form and to deal with your enquiry, please view our Privacy Notice