Self-Referral Your Referral Disability or Injury? Autism Brittle Bones Brain Injury BSL Counselling England BSL Counselling Wales & Scotland BSL Counselling Ireland CODA Ehlers-Danlos Syndrome Endometriosis Cerebral Palsy Hearing Loss Muscular Dystrophy Continued Limb Loss Lumber Spondylosis Multiple Sclerosis Rare Genetic Disorders Road Traffic Accident Skeletal Dysplasia Spina Bifida Spinal Cord Injury Sight Loss Carer Not Listed Disability Brief explanation about your disability or injury. The NHS ASD DisabilityPlus are not able to apply for Free Funding. Visit your General Practice, they can refer you to specialist NHS Funded ASD service . The NHS BSL DisabilityPlus are not able to apply for Free Funding in Ireland. Please visit your GP for mental health counselling. The NHS BSL DisabilityPlus are not able to apply for Free Funding in England. SignHealth have a national contract with NHS England. Their website:https://signhealth.org.uk/with-deaf-people/psychological-therapy/ Road Traffic Accidents DisabilityPlus are not able to apply for Free Funding if you have NOT obtained a disability through the accident. Carer Counselling DisabilityPlus are not able to apply for Free Funding for Carers CODA Counselling DisabilityPlus are not able to apply for Free Funding for people who are CODA. Hearing Loss Counselling DisabilityPlus are not able to apply for Free Funding for people with Hearing Loss outside of Wales. Topics Counselling For? Adjustment Disorder Abelism Anxiety Autism Chronic Pain Chronic Fatigue Depression Grief & Loss Eating Problems Low Self-Esteem Life Changes Mood Swings Trauma Social Anxiety OtherOther Address & Contact Your Name? PostCode? Date of Birth 00/00/0000 Phone Number? Email * Gender? Summary Why would you like support? Preferred * Assessment Session for Free Funding Self-Paid & Assessment Session (Free Funding) Self-Paid only Employment Support OtherOther Submit If you are human, leave this field blank. Self-Referral Form Your Referral Referral Topic Ataxia Autism Brain Injury Deaf Cerebral Palsy CODA Limb Loss Muscular Dystrophy MS Spina Bifida Spinal Cord Injury OtherOther ASD NHS Funded ASD NHS Funded DisabilityPlus are not able to apply for Free Funding. Visit your General Practice, they can refer you to specialist NHS Funded ASD service . Therapy Topics? Topic? Adjustment Disorders Anxiety Chronic Pain Depression Chronic Fatigue Eating Problems Low Self-Esteem Life Changes Mood Swings PTSD Social Anxiety OtherOther Address & Contact Your name? Postcode? Date of birth 00/00/0000 Phone number? Email * Your gender? What you would like to be referred to as? Anything to add? Reason for Referral Preferred Referral * Assessment Session for Free Funding Self-Paid & Free Funding Application Self-Paid Only Employment Support OtherOther Submit If you are human, leave this field blank.
