Request a Review of Existing Support Arrangements

Use this form if you currently receive a service and are looking for it to be reviewed and make significant changes to your support, e.g. decrease or increase your support or request a change of care provider.

INTROTEXT
1. This is not an emergency service. If you are concerned someone may be at risk of immediate harm, abuse or neglect please contact one of the following services:
  - Emergency Services - Phone 999
  - Police - Phone 101
  - NHS24 - Phone 111
  - Adult Support and Welfare Concern Form
  Outwith office hours, contact the Social Care Emergency Team (SCET) on 01506 281028 OR 01506 281029
  
  Before requesting a review of support arrangements have you had a look at our Independent Living and Support Hub
  
  Use this form to request a review of the existing support you receive. If you currently have an allocated worker, please contact them directly. If you do not receive support currently, please use the Adult Social Work Referral Form.
  
  Any change to support will be subject to a review under the Eligibility Criteria and the Non-Residential Contributions Policy.
  
  Find out how we will use your data: Read our Privacy Policy
Are you completing this form on behalf of someone else?
1. Yes
2. No
Label
1. Is the person impacted aware and in agreement to this review? (optional)
  
  Yes
  
  No
  
  Adult's Protection Case
2. CONSENTDETAILS
  1. Unfortunately, if the person you are referring is not aware of the review and has not given their consent we cannot progress with the review at this stage unless you have either Power of Attorney or Guardianship for the person. Please tell us why you cannot seek consent from the person.
    
    You may wish to call us to discuss this issue directly.
  2. Please select your reason (optional)
    
    Power of Attorney
    
    Guardianship
    
    Other
  3. POA
    
    Please provide Power of Attorney details (optional)
  4. GUARDIAN
    
    Please provide Guardianship details (optional)
  5. OTHERDETES
    
    Please provide your reason e.g. communication issues or cognitive issues (optional)
3. NEXTBUTTON

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Help shape the future of health and social care services in West Lothian

Request a Review of Existing Support Arrangements

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Request a Review of Existing Support Arrangements