Children’s Occupational Therapy Returners Referral Form


I cannot submit the referral form.
Go back and check the form as you may not have completed all the mandatory sections.

I have submitted the referral form but have not received a receipt email.
Please check that you have entered your email address into the form correctly with no typographical errors (this will need to be the email field in the referral section). Please also check that the receipt email has not been filtered into your junk\spam folder. Please note that if you have high level security settings this may be stopping the receipt email from coming through.

The information I have does not fit in the sections or on the form.
Check the referral criteria as you may not be referring to the appropriate service or you may need to gather more information before you make the referral.

There is not a section related to Sensory Processing. How can I make a referral for this type of assessment?
The Gloucestershire Children’s Occupational Therapy Service offer Occupational Therapy Assessments around a child’s functional needs within their everyday activities. Children’s Occupational Therapists are trained to look at a child/young person in their environment and the everyday tasks they need and want to do. An Occupational Therapist has specialist skills in task analysis and in looking at the person holistically by considering how underlying skills such as motor and visual perceptual skills, medical conditions, motivation to do a task, cognitive ability in line with developmental age and how the child is processing stimuli as well as how environmental considerations impact on the child’s ability to do the task. Sensory processing is one tool which can be used within the Occupational Assessment and therefore referrals are accepted for an Occupational Therapy assessment and the trained therapist would decide on the appropriate course of intervention based on the needs of the child on assessment.

Can I talk to someone about completing this referral form?
Please email us at 

Do I need to complete a referral form if the child has received previous input for the Gloucestershire Children’s Occupational Therapy Service?
If the referral is around an issue that the Gloucestershire Children’s Occupational Therapy Service provided input for and this ended less than 3 months ago please make contact with us to discuss further

OR If this is a new functional issue please complete the form for a new referral to the service.

OR If this a query around specialist equipment which the child has been provided with by the Gloucestershire Children’s Occupational Therapy Service please contact the locality office directly (contact details were provided with the equipment).