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290291
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Autism Spectrum Disorder (ASD) Consultation
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Home address area (please select)
Bath
Chew Valley
Norton Radstock
Other Local Authority Area (e.g Wiltshire, Bristol)
If other, please specify
Age of child/young person
Please tick if you know what support your child has:
SEN Support
Education, Health and Care Plan
Don't Know
In addition to autism does your child/young person have any other special educational needs and/or disabilities
Moderate Learning Difficulty
Specific Learning Difficulty (SpLD)
Severe Learning Difficulty
Profound Learning Difficulty
Speech and Language
Social, Emotional and Mental Health (SEMH)
Hearing Impairment (HI)
Visual Impairment (VI)
Multi Sensory (MSI)
Physical Impairment (PI)
Medical Needs
Other
Please tick all that apply
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