Short Breaks assessment

How do I apply?

If you would like to apply / enquire about short breaks please complete the online form below:


Parent/Carer details

Preferred method of communication *

Child's details


Please tick any other assessments that have already been completed.

Disability Living Allowance (DLA)


About your child

If your child had the help they needed, what would they like to do in their leisure time?
Have you tried to or thought about accessing any of the above activities?
If yes what difficulties did you encounter?

About your home and family

Are there any other things that impact on you parenting and supporting your child?
Where do you currently get help and support from?


Please note that whilst Children’s Services would always wish to have your consent before any information is sought or shared, we shall proceed without your consent if we have reasonable cause to believe that your child(ren) may be at risk of significant harm.

City of York Council are testing a new innovative parent lead, online self assessment for parents with disabled children, in order to access low level support and services. This process will be proactively supported by volunteers, who can signpost and help families achieve the outcome they need.

We think this self assessment will enable some parents and families to receive the information, services and support through a quicker, simpler and more accessible process. All parents with disabled children have a right to request at any point a more detailed social work assessment of their child's needs. The Child Health and Disability team may also at any point decide that a more detailed social work assessment is required in order to understand and meet the child and family’s needs. 

Thank you for taking time to complete this form.

For more information please use the 'Frequently asked Questions' link.

Related pages

Family Information Service

01904 554444