Child Autism Enquiry | Elysian Psychology

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Home
About Us
Services
Neurodiversity Assessments
Meet Our Team

Location
- Nottingham Psychology
Fees
Contact
Crisis Page
Join Us

Child Autism Enquiry

Child Autism Enquiry

We are not a crisis service.

If you feel concerned about threat to life for yourself or a child, please visit our crisis page for other professionals to contact. We are unable to offer appointments to anyone who may be a threat to themselves.

CRISIS INFOMATION

Contact Us

Parent / Career / Guardian

Please fill out your infomation below.

Name* First Name

Last Name

Date Of Birth

Email Address

Contact Number

Child Details

Please fill out the below details on behalf of your child.

Name

Date of Birth

Is your child in full time education

Yes

No

Are you the birth parent?

Yes

No

Does your child live with both birth parents?

Yes

No

Are there any legal matters that we need to be made aware of?

Yes

No

Are there any elements of self-harm?

Yes

No

If yes, please specify.

I would like to book an Autism Pre Screen Appointment

Yes

No

New Field:

Funding Your Session

Will you be self-funding?

Yes

No

Will you be using private health insurance?

Yes

No

If yes, please specify your insurance provider..

Are you happy for us to triage your details and share your details with the Clinical Psychologist, who has the correct expertise for your child's difficulties?

Yes

No

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First Floor, 32 Gordon Road, West Bridgford, Nottingham, NG2 5LN

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