Please ensure you have the evidence of an identified and persistent speech language and communication need, as you will need to refer to this and submit it with the referral form.

Information on types of evidence to submit

Completing a Referral

You will also need the following information in order to complete the referral;

• Child’s full name, date of birth and home address
• Child’s GP name and address
• Parent/carer names
• Parental consent to refer (verbal with date and who consent was provided to)
• Safeguarding information, where relevant
• Names and contact details of any other professionals involved
• Information of any medical diagnoses
• Evidence of your initial speech/language screen, intervention record, and rescreen (speech sound screen if appropriate).

Please download and complete the speech sounds screen here before filling in the referral form.