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Contact me to book any service or your Home, Telephone or Skype Consultation HERE

ALL DETAILS SENT TO ME WILL BE KEPT SECURE IN LINE WITH THE DATA PROTECTION ACT (1992) AND DESTROYED WHEN NO LONGER RELEVANT

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Contact Details
Name
Address 1
Address 2
Address 3
Town/City
County
Postcode
Country
E-Mail
Telephone
Skype

 

Details of person on autistic spectrum
Name
Age
 
Diagnosis
Date of Diagnosis

Other or Additional Diagnoses / Other Medical Conditions

Other Professionals Involved (e.g. speech and language therapist)

Interventions currently and previously used

Other information about your child

 

Other Information
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The more information you can give here, the more time there will be to discuss specifics during the consultation.

No details will be passed on to 3rd parties.