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Independent Mental Capacity Advocacy (IMCA) Referral Form

The role of an IMCA is defined in the Mental Capacity Act 2005 (amended 2019) and before we can assign an IMCA certain specific information must be provided. 

A failure to provide this required information can lead to a rejection in the referral and/or delay in an IMCA being appointed.

You will receive an automated acknowledgement of your referral on the same day, or within a working day.

The referral will then be checked to ensure all required information is included prior to allocation, and you will be notified who this is. The advocate will make contact so you have their details.

It is your duty to ensure that the required information is supplied and if you are the Decision Maker you have a statutory duty to engage with the allocated IMCA.

Two of the extension functions for IMCAs included in the Act have now largely been replaced by (non-instructed) Care Act Advocacy i.e. annual care (accommodation) reviews and safeguarding.
Please consider if it is more appropriate to use this service.

If you need support to complete this form, please contact us on 0151 347 8183.

Name
Equal opportunities form completed?

Section B


What is the Best Interest Decision?

Section C

Has capacity assessment been completed?
(e.g. Social Worker)

Section D

Section D: Family and Friends

Does the referred person have a family?
Does the referred person have any friends?
Are the person’s family appropriate to be involved in the best interest decision?

Section F


Is the referred person aware of the advocacy referral?