OT - Occupational Therapy Assessment Contact & Referral

About this request

Please select the option that best describes this request.


1) The Occupational Therapy Service

Occupational Therapists help people with physical disabilities to be independent in the home through the provision of equipment or adaptations. To find out if you or someone you know would benefit from an Occupational Therapy Assessment, please visit the Occupational Therapy pages to learn more.

Please use the following link to access the pages. A new window will open and once you have finished select the 'Back' button on your Browser to return to this form.

Link here......

2) This Referral Form may be completed by any of the following:

2.1) The person who would like to receive an assessment (The Client).
2.2) A relative, friend or other contact on behalf of the person seeking an assessment (The Carer).

To make the form as clear as possible the person seeking an assessment is always referred to as "The Client" rather than "you" or "your", although in many cases the client will be filling in the form on their own behalf.