If contacting a helpline isn’t for you

 

 

We have included the option to contact us via an online referral form. We have three referral forms for you to use. Which one you use depends on who you are, as you may be an autistic individual, a parent or carer, a professional or a third party. Please check the description above each referral form to find out which is the most suitable for you to complete.

Once you have completed the form, please click ‘submit’ and your form will find it’s way to one of the team. We will then look into your enquiry ad contact you once we have sourced the requisite information or support.

 

Pašnodarbinātības veidlapa

Aprūpētāja / vecāka nosūtījuma veidlapa

Profesionālā / trešā puse
nodošanas forma

Before completing this referral form, please note the following: this referral form is for completion by a professional or third party affiliated with an autistic individual enquiring about support for paši. If you wish to enquire about support for someone else, please telephone our helpline. 

If you are a professional seeking training or awareness raising relating to autism to be implemented in your own organisation or service, please contact our service via the enquiries box or email address provided, detailing your requirements. 

All the following sections must be completed if possible:

Vai personai, ar kuru sazināties, ir oficiāla ASC diagnoze? Lūdzu, izvēlieties kādu no šīm iespējām:

Tick the box below to confirm the person who requires support lives in Derby/Derbyshire?

Lūdzu, atzīmējiet zemāk esošo izvēles rūtiņu, lai piekristu mums sazināties ar jums:

1 + 2 =

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