East Sussex Children’s Integrated Therapies referral form

You can use this form to refer your child for Speech and Language Therapy, Occupational Therapy, Physiotherapy and Adaptations 

Before you start to complete the referral form, please refer to our referral criteria. 

In some cases for Speech and Language and Occupational Therapy additional information will need to be uploaded to support a referral as explained below

For speech and language therapy 

• Please note that if you are making a referral for Eating and drinking, Early Years Language or School Aged Language you will need to have completed and saved the relevant referral resources on your own system, ready to upload at the end of this referral form.

For occupational therapy

• If you are a school referring a child for motor co-ordination difficulties, please note that you will be required to upload evidence of the child having completed Jump Ahead/Sensory Circuits.
• If you are a school referring a child for sensory processing difficulties and/or emotional regulation difficulties please note that you will be required to upload evidence that the child has completed Zones of Regulation sessions.

If you are a health or education professional we recommend completing this form with the child’s parent or carer present as there are questions that require their knowledge of the child. If you are not able to do this it is important that you have met beforehand with the parents or carers and have the answers to these questions to hand.

If you have any questions about making a referral for a child or young person please contact Therapy One Point on 0300 123 2650. Please check our website for opening times.

Please note, all fields marked with an asterisk are mandatory and if not completed the referral will be declined. Thank you.

Start referral here...