Additional information documents for making a referral

If you are thinking about possible autism please begin by reading our guidance on how to request help first:

• For families: How to request help for possible autism and/or ADHD: information for families
• For professionals: Guidance to our request for help process for possible autism and/or ADHD for professionals 

Once you have done that, please download the relevant additional information document in the sections below. Please complete the form and save it. Then go to the Berkshire Healthcare online referral form, complete it and upload this document when prompted. Please see the first section for some advice on filling in the forms.

Please note, we will not be able to proceed with the request for help unless you have uploaded this additional information. You will also need to upload the support plan where relevant.

Additional information document

How should the additional information document be completed?
The additional information documents are designed to support discussion about the child or young person’s needs and how they can best be supported. Ideally they will be completed together although they can also be completely separately, and the completed information discussed together. They are intended to build a complete picture of the child/young person across settings.  

Some questions on the additional information forms and the online referral form are the same, do I need to fill them both in?
The online referral form is for use by all our services, not just autism and ADHD, therefore you may have already answered some of the questions when filling in the additional information document. If you have answered a question within the additional information document and it is repeated in the online referral form, please say ‘refer to additional information document’. 

What if some of the formatting changes as I fill in the additional information form?
Please bear in mind that as this is a Microsoft Word document, some of the formatting may be lost as information is added and some sections move over to the next page. Please do not worry about this as the triage team will be able to work with the information in whatever format you provide it. We are continuing to look at the best options for the form to provide you with the best experience.  

Do I need to save the additional information document?
Yes. Please download the document and save it to your computer. Once completed, please fill in the online referral form and upload the document when prompted. 

Online referral form (used for all referrals ie autism, ADHD, CAMHS, CYPIT)  

Can I use special characters?
You can use some special characters – however the online referral form is designed to keep the identifiable information you submit safe. This means there are certain characters that you will not be able to use. We will alert you if you try to submit a disallowed character. For example: you will not be able to enter '1:1' you will need to enter 1 to 1 or one to one etc. The online form gives guidance on what characters are accepted. The special characters accepted are : - ' ; , . ( )  

Can I copy and paste text?
You can copy and paste text into the form, although there would be an issue if it contained a special character that was not valid, and this would need to be removed.  

Is there a save function?
The online form retains the information as long as you keep the page open – however not if you close the page. The form does not have a save function, however if you keep the webpage open, the information you have put into the form will not be lost. Please not close the website or the information you have added will be lost.  

How many documents can be submitted? 
You will be able to upload two documents, the additional information document and the support plan. If there are further documents that you need to send, please email them to: CYPADHDandAutismTriage@berkshire.nhs.uk 

If you have any questions 

If you have any problems filling in this form, please email CYPADHDandAutismTriage@berkshire.nhs.uk 

Please download and fill in this form for an autism assessment for a child aged 2 years 6 months to 4 years.

Please fill in this form for autism assessment for a child or young person aged 5 to 17 years 5 months.

Please fill in this form for autism assessment (child or young person aged 5 years to 17 years 5 months) AND ADHD assessment (child or young person aged 6 to 17 years).

Please fill in this form for ADHD assessment for a child or young person aged 6 to 17 years.

Existing ADHD diagnosis  (age 6-17 years)

Please fill in this form if the child/young person has an existing ADHD diagnosis and you'd like to make a request to consider starting ADHD medication (aged 6 to 17 years).

Existing ADHD diagnosis and already taking ADHD medication (age 6-17 years)

Please fill in this form if the child/young person has an existing ADHD diagnosis and is already taking ADHD medication (aged 6 to 17 years) and you would like to request taking over ADHD medication.