Use this service to submit a request for an ADHD or autism referral.
Please read the below information and only submit the form if you meet the below criteria.
Patients can submit a Right to Choose referral if the following conditions are met:
- the NHS practice is in England
- the GP has agreed to make clinically appropriate outpatient referral
Patients cannot use Right to Choose if they are:
- already receiving mental health care following an elective referral for the same condition
- referred to a service that is commissioned by a local authority, for example a drug and alcohol service (unless commissioned under a Section 75 agreement)
- accessing urgent or emergency (crisis) care
- accessing services delivered through a primary care contract in high secure psychiatric services
- detained under the Mental Health Act 1983
- detained in a secure setting. This includes people in or on temporary release from prisons, courts, secure children’s homes, certain secure training centres, immigration removal centres or young offender institutions
- serving as a member of the armed forces (family members in England have the same rights as other residents of England.)
You can use this service if you:
- are registered at the surgery
- have read and understood the above information
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
You can also phone us on Brookside Surgery 0118 966 9333 or Chalfont Surgery or Winnersh Surgery or Wilderness Road Surgery .