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Orchard Surgery NHS GP Surgery in Dereham

Child ADHD or autism (ASD) referral request

Child ADHD or Autism (ASD) Referral Request

Section

Please specify the condition for which you are seeking a referral: *

ADHD

ASD (Autism)

I would like the patient to be referred via:

NHS

Right to choose

Autism providers

Please select a provider from the list below: *

Help for Psychology

The Owl Centre

Evolve Psychology

Paloma Health

ADHD providers

Please select a provider from the list below: *

Help for Psychology

The Owl Centre

Evolve Psychology

Please provide details of your symptoms/traits to support your referral: *

If you are human, leave this field blank.

Commercial Road
East Dereham
Norfolk
NR19 1AE

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01362 692916

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