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Getting help

Request a children’s occupational therapy assessment

Is your concern regarding help with a wheelchair?

Yes
No

Please call Liverpool Wheelchair Service on 0151 296 7765

Is your concern about an assessment of sensory processing difficulties?

Yes
No

A referral is not required to get support with sensory processing difficulties. Is your child six years or over?

Yes
No

Please contact ADDvanced Solutions on 0151 486 1788 or visit ADDvanced Solution to book a place at an awareness session.

Please leave your details and we can send you information about the Sensory Processing Awareness Sessions and Parent Workshops for children 5 years and under at the Children Centres.

Please leave your details and we can send you information about the Parent Consultations.

Child first name

Child surname

Child date of birth

Contact number

Is your concern regarding help with handwriting?

Yes
No

We can only accept referrals to assess handwriting difficulties if the child's school has already tried to help with this. Have you checked with the School SENCO to make sure support is in place before making the referral?

We can only accept referrals to assess handwriting difficulties if the child's school has already tried to help with this.

Yes
No

For help with handwriting contact the child's SENCO.

Please complete this form

Are you a...

Professional

Parent / Carer

First name

Surname

Postcode

Enter address manually

Select an address

My address isn't listed

Profession

Organisation

Contact Number

Consent

Have you been given consent from the parent or those who have parental responsibility to make this referral?

Unless the child is at risk of significant harm, you must speak to their parent or carer to gain consent and make them aware of how we share information. If you fail to get consent or explain why you could not, your referral will be rejected.

Have you been given consent from the parent or those who have parental responsibility to make this referral?

Yes
I have parental responsibility and I give my consent
No

We are sorry but as you have not sought parental consent, we cannot process your request.

About the child

First name

Surname

Date of birth

Other names / aliases

Gender

Male

Female

NHS number

Postcode

Enter address manually

Select an address

My address isn't listed

Is there an Early Help Assessment Tool (EHAT) in place?

Is there an Education, Health and Care Plan (EHCP) in place?

Who else lives at the child's address?

Other family members

Family member's first name

Family member's surname

Date of birth

Relationship to child

Are there any risks we should know about before contacting the family?

Yes

If yes, give details

About the child's GP

Name

Surgery name

Has the child had a diagnosis or are they currently undergoing medical investigations?

Yes

If yes, give details

Is the child in school or nursery?

Yes

If yes, give details

Please indicate which areas the child requires support from occupational therapy

Which of the following are reasons for your referral?

Please tell us what the impact is on the child's, development and health/safety right now. Is there a risk of future harm?

What has already been tried to help make things better?

How can Occupational Therapy help?

If other, please give details*

Which professionals are currently working with the child?

Is there anything else you think we should know about?

Yes

If yes, give details

When you submit this form using the button below you are agreeing to our privacy notice and terms. Find out how we share information.

Add Document

Please attach any supporting documents eg handwriting samples, school reports, doctors letters, EHAT.

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