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Speech & Language

Communication Request for Support

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 request for support form.

Information on types of evidence to submit

Completing a Request for Support

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

  • Child’s full name, date of birth and home address
  • Child’s GP name and address
  • Parent/carer names
  • Parental consent (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 request for support form.

Documents to Complete

Pre School Request for Support

Download

School Aged Request for Support

Download

Intervention Form

Download

Speech Sound Screen

Download

Submitting Your Completed Request for Support 

Once your request for support and supporting information is completed please email to;

ccs.nandw-salt-jon@nhs.net

Alternatively you can post the completed form to;

Norfolk and Waveney Children and Young People's Health Services
Children's Speech & Language Therapy,
Unit 3, Cringleford Business Centre
Intwood Road
Norwich, Norfolk
NR4 6AU

Please attach any recent and relevant reports, and the speech sound screen if appropriate.


Who can Help?

You can contact the Norfolk & Waveney Speech & Language Therapy Service by calling Just One Number on 0300 300 0123. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays) and 9am-1pm on Saturdays.

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