Consent: If you are referring someone over the age of 16 and are not the person seeking the assessment, you must confirm you have their written consent. This can be: 

• a signed letter 
• an email from the person’s own email address.

If the person is unable to consent, you must provide evidence such as:

• a health and welfare power of attorney 
• a formal capacity assessment.

We will request copies of these upon receipt of the form. 

Funding: If the assessment will be funded by someone else, we will require proof of funding. This may include: 

• a letter from your GP 
• written confirmation from an external organisation. 

We will not progress the referral until this has been received.

Developmental History Contact (Adults): For adult assessments, we aim to gather a developmental history from someone who knew the individual during childhood. This could be: 

• a parent 
• a family member 
• a friend or relative.

This person does not have to attend the assessment but you may choose to bring them with you. If there are difficulties in identifying someone and/or providing their contact details then please advise us when you complete the form.

Parent/Carer Details (Children & Young People): We ask for contact details of a parent or carer. 

Educational Setting Contact (Children & Young People): Please provide details of a professional at the child or young person’s educational setting. This helps us gather useful supporting information.

Reports: If you have relevant documents (e.g. speech and language therapy reports, psychological assessments, or hearing and vision tests), please indicate this at the relevant section of the form and we will contact you to request these.