Suspected autism referral request

Use this service to request a referral for suspected autism.

You can use this service if you:

• are registered at the surgery

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

We ask for these details to verify your records with the NHS.

Start now

You can also phone us on 0161 225 6699.