Staff referral form

If you are an NHS staff member, Local Authority staff member, or third sector organisation supporting a family who will either need neonatal care (e.g. high risk pregnancy), currently in neonatal care (NICU/SCBU) or who have been discharged from a neonatal unit, you can now refer in using this digital form.

Leo’s also provides dedicated neonatal bereavement support. Staff are able to referr in on the dedicated bereavement referral form listed below.

Leo’s covers the following hospitals, and geographical areas which support these hospitals: The University Hospital of North Tees, The James Cook University Hospital, The Darlington Memorial Hospital, The University Hospital of North Durham and Sunderland Royal Hospital.

Please use the staff guidance form if you’re unsure of whether to refer a family into Leo’s, which is available via your unit manager or email judith@leosneonatal.org / lottie@leosneonatal.org for a copy to be issued.

Leo’s Staff Referral Form

Leo’s Bereavement Referral Form


Facts & Figures

79% of parents said a neonatal stay affected their mental health

Leo’s saw a 337% increase in need due to COVID-19

Did you know, reading to your baby in the NICU helps their development?

Leo's Neonatal

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