We accept referrals from professionals and families for children aged between 3-18 years and their parents/carers affected by the death or terminal illness that has a prognosis of a year or less for survival, of someone important to them. Please note our services are currently restricted to certain geographical areas. Please refer to the details at the bottom of this page to see if you are eligible before submitting your referral form.  

Once a referral has been received, we aim to telephone you within 48 working hours to arrange a face-to-face or telephone assessment appointment with the adult parent/carer of the child/children being referred. 

The assessment will last approximately 1.5 to 2 hours and is an opportunity for us to assess your family's individual needs and for you to find out about the services and type of support we may be able to offer.

We endeavour to offer the most appropriate service as close to home as possible at our venues in Newark & Sherwood, Mansfield, or Bassetlaw. However, this is dependent on matching support available which will be discussed with you.

To access our services please download the correct form from the list below, fill it in and send it to:





[email protected]



Children's Bereavement Centre

3 Kings Road



NG24 1EW

Child referral form - self referral - download

Child referral form - professional - download 

Adult referral form - download

If you have any problems downloading or completing a form, please contact us on 01636 551739.