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, 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.

Self referral form

go to this form

Third Party Referral form

go to this form

Carer/parent referral form

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 themselves. If you are a carer or parent and wish to enquire about support for someone else, please telephone our helpline.

All the following sections must be completed as thoroughly as possible:

Your first name

Your surname

Please state your role in relation to the individual with ASC. i.e. parent

Does the individual you care for/parent have a formal diagnosis of ASC? Please select one of the following: Does the individual you care for/parent have a formal diagnosis of ASC? Please select one of the following: Yes No Unsure On waiting list

Reason for referral – please give as many details as possible:

Your Email address

Your Phone number

Your Postcode

Please tick the box below to consent to us contacting you: Please tick the box below to consent to us contacting you: By checking this box you agree for us to contact you

13 + 13 =

If contacting a helpline isn’t for you!

Self referral form

Third Party Referral form

Carer/parent referral form

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