Adult Speech and Language Therapy Referral Form

If you have any queries regarding the completion of this form, please contact the Adult Speech and Language Therapy Service on 0300 422 8105 or ghc.slt.adults@nhs.net

Please note: This referral form takes roughly 20 minutes to complete.

Please note: It is beneficial to gather additional information before you complete this form, e.g. a record of the person’s weight and any information relating to recent chest infections.

Please note: If this form is left unused for more than 2 minutes, it will timeout and you will need to restart. Please ensure you complete the form in one go.

Please have all digital documents ready. There is an option to upload these files at the end of the referral form.