Web-Referral Form
Would you, or someone in your family, like to access our services?
Please fill in the form below, and let us know what service you would like to access. Pop your email address in at the bottom of the form, and you will be sent a confirmation that the form has been successfully submitted.
Please DO NOT submit the form more than once.
You should receive a response to the form within 10 working days, if you do not, please contact us by email so that we can follow up, using the email details below:
If you are looking for support for a neurodivergent adult, please contact adults@adhdandautism.org. For all other services, please email enquiries@adhdandautism.org.
Are you are a professional referring a client to our services?
Please fill in the form below, and let us know what service you would like the client to access. You will have been advised to use specific service types if appropriate. Please enter the client’s email address at the bottom of the form if you wish them to be sent a confirmation that the form has been submitted.
Thank you.