Children's Speech and Language - Feeding - NORTH ONLY

For Childrens Services in Huddersfield please contact the children’s therapy department on 01484 344299

Children's SLT - Feeding Referral

Child's details:
If contact details are incorrectly input where mandatory the referral cannot be processed
Overseas visitor?
Is the patient's main spoken language English?
What is the patient's main spoken language?
Consent for contact by email:*
Referral discussed with parents:*
Consent gained for the referral*
Without consent the referral will not be accepted
Consent gained for the child’s electronic medical record to be shared*
Without access to the child’s medical record, we will be extremely limited in what care we can offer and this may affect the child's progress
EHC Plan or Statement
Optional Attachment
Referral
Information Required

Please note completing this referral is not automatic acceptance of the referral by our service. The referral form will now be forwarded to the Speech & Language Therapy Team for consideration and you will be notified of the outcome

If you do not receive an email acknowledgement your referral has not been submitted. Please check that all details are correct, mandatory fields completed and re-submit.