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Make a Referral to the Baby Bank

Thank you for being willing to refer a baby and/or parent to The Parish Trust's Caerphilly Baby Bank and Maternity Supplies Project. Please be aware that this form is for professionals only. If you are a parent in need of support for yourself or your baby, please contact your health visitor, social worker, or other professional who is caring for you. Once this form is submitted, our team will contact you and work with you to arrange for you to collect the support package at a date and time convenient to you, so that you can pass it on to the baby and/or parent(s) that you're supporting.

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Referrer Details

Please ensure that this email address is an official work email address.

Please ensure that this is the best number for you, so that we can contact you to discuss this request.

As you have informed us that you are a NICU Nurse/Sister, we assume that you will need the items delivered to the ward. Please give us full details of a contact, address, and any other helpful information, as well as the timeframe in which the items are needed.

eg - NICU Ward, Grange University Hospital, Contact: Joanne Bloggs, Needed within the next 2 weeks. Baby is currently 27+2.

Parent/Carer Details

Filling in this page is optional. However, we strongly encourage you to share details with us with the parent's consent in order for us to offer other services that may be of benefit to them such as food support, free data, calls and texts, and ongoing support.

The Request

Please use this page to make your request. You can request maternity supplies which will include items such as maternity clothing and toiletries, or you can request for a child. You can only request for one person (adult or child) at a time. If you need to request for an adult and a child, or multiple children, please complete another referral request after submitting this one.

Maternity / Antenatal Pack

The Maternity / Antenatal Pack is a request for maternity/nursing clothing and hygiene items.

Baby/Child (up to 5 years of age)

Please select as many options as are required for the baby in question.

Please tell us details of the premature sizing needed (such as rough weight of baby if you can, so that we can try and accommodate the request as best as we can) If it doesn't matter, please just put N/A.

Please put N/A if you'd just like to request general toiletries

Please note, these items are subject to availability and not guaranteed.

Final Details

Tick all that apply.

This will not affect the ability for the family to receive support from us.

Food

Get help from our CARE Project

Data

Get help with mobile internet data

Baby Items

Get help with caring for your baby/young child

Grief & Bereavement

Get help with our bereavement support service

The Parish Trust is preparing to move to a new location. Please Click Here for full details about our move, and how it affects you.

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