NHS Right to Choose: Patient Request Form
Use this form (Click HERE) to ask your GP to refer you (or your child) to The Warren Neurodiversity Service for an ADHD or autism assessment, funded by the NHS under your legal Right to Choose. We are a consultant-led, CQC-registered service commissioned by NHS Hampshire and Isle of Wight Integrated Care Board (ICB), and we accept NHS Right to Choose referrals from across England. Your GP will decide whether a referral is clinically appropriate, this form is your request, not the referral itself.
GP Referral Form — NHS Right to Choose
The complete referral package: four items
A referral can only be accepted when all four items are received together: (Click HERE)
1. Patient Request Form (The WNS RTC-01), completed and signed
2. GP Referral Form (The WNS RTC-02), completed by the GP practice, with the relevant screening questionnaires attached (ASRS, SNAP-IV and/or AQ-10)
3. GP referral letter, confirming the referral is clinically appropriate
Referrals missing any of these items will be returned to the practice.
Download Forms
01276 916457