إذا لم يكن الاتصال بخط المساعدة مناسبًا لك!

We have included the option to contact us via an online referral form. We have three referral forms for you to use, depending on who you are, as you may be: an autistic person, a parent or carer, or a professional or 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 its way to one of the team. We will then look into your enquiry and contact you once we have sourced the requisite information or support.

استمارة الإحالة الذاتية

نموذج إحالة الطرف الثالث

نموذج إحالة مقدم الرعاية / الوالدين

Before completing this referral form, please note the following: this referral form is for completion by carers or parents of autistic people enquiring about support for أنفسهم. If you are a carer or parent and wish to enquire about support for someone else, please telephone our helpline.

يجب إكمال جميع الأقسام التالية بأكبر قدر ممكن من الدقة:

هل لدى الفرد الذي تقوم برعايته / والديه تشخيص رسمي لـ ASC؟ الرجاء تحديد واحد مما يلي:

يُرجى وضع علامة في المربع أدناه للموافقة على اتصالنا بك:

15 + 10 =

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