Please click here to download the referral form file. Fill in all details clearly and send the completed form back to us

Via post, please send it to:

Ealing Child Contact Centre

St.Andrew’s Church Centre

Mount Park Road

Ealing, W5 2RS

Or via email, please send it to:

As soon as we receive the application we will be in touch via telephone or email. Both parents will be invited at the earliest possible opportunity to come on a Saturday morning to visit the centre for a pre-visit to assess eligibility and discuss arrangements.