Online Referral Form

Estimated time to complete the online referral form: 5 - 25 minutes

Thank you very much for your completion.

Your Appointments Coordinator for this assessment location will now process your referral and will be in contact with you as soon as possible.

Once your appointment has been confirmed you will receive email confirmation and an SMS reminder prior to your appointment.

If you have any questions in the meantime, please do not hesitate to contact the team on 01457 835 568 or email

We also require a copy of your approval letter from your funding body (DSA 1), together with any supporting evidence (diagnostic report/doctors letter/medical evidence, etc). Please email this to:-