[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-170637-105":53,"doc-detail-170637-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","adult-right-to-choose-referral-form-june-2025","Adult Right to Choose - Referral Form - June 2025","","Referral form for adult autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) assessment pathways, intended to be completed and signed by a GP. Sets eligibility for adults aged 18 and over, outlines face-to-face assessment options in Canterbury (Kent) and Basingstoke (Hampshire), and allows online assessments when clinically appropriate. Includes ADHD medication and shared care guidance after diagnosis, specifies what referrals can cover, defines exclusion criteria, and provides instructions for sending supporting documentation and contacting the service.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/adult-right-to-choose-referral-form-june-2025/170637/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/adult-right-to-choose-referral-form-june-2025/170637.png","ImageObject",442,249,{"name":88,"@type":89},"Theodora","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-24","2026-09-01",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",9,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"Who is allowed to complete and sign this referral form?","Question",{"text":109,"@type":110},"Only a GP should complete and sign the form.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What are the assessment options for adults in the ASD and ADHD pathways?",{"text":114,"@type":110},"Both pathways offer face-to-face assessments in Canterbury (Kent) and Basingstoke (Hampshire), and online assessments when clinically appropriate.",{"name":116,"@type":107,"acceptedAnswer":117},"What happens after an ADHD diagnosis if medication is initiated through Psicon?",{"text":118,"@type":110},"After titration and stabilization, shared care with the patient’s GP is requested; if shared care is not possible, ongoing reviews and prescriptions continue with Psicon.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},170637,1788273562,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":126,"read_time":76},687197207919,"https://ap-avatar.wpscdn.com/avatar/a000253d6f5f7c60be?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779446848396160552","\u0003NHS Template\u0004\n\u0003Adult Right to Choose \u000bReferral Form\u0004\n\u0003June 2025\t\u0004\n\u000f\nAdult Right to Choose\nThis form should only be completed and signed by GP.\nFor this service, please email this referral form (along with any other supporting documentation) to: \u0013 HYPERLINK \"mailto:kmicb.psicon.adults@nhs.net\" \u0014kmicb.psicon.adults@nhs.net\u0015\nAutism spectrum disorder (ASD) assessment pathway:\nEligibility: For adults aged 18yrs and over.\nAssessment Options:\nFace-to-face assessments available in Canterbury (Kent) and Basingstoke (Hampshire).\nOnline assessments (when clinically appropriate).\nAttention Deficit Hyperactivity Disorder (ADHD) assessment pathway:\nEligibility: For adults aged 18yrs and over.\nAssessment Options:\nFace-to-face assessments available in Canterbury (Kent) and Basingstoke (Hampshire).\nOnline assessments (when clinically appropriate).\nAdditional Information for ADHD Pathway:\nPsicon can provide ADHD medication following a diagnosis of ADHD where clinically appropriate.\nIf medication is initiated through Psicon:\nOnce titrated and stable, shared care with the patient's GP will be requested.\nIf shared care is not possible, ongoing reviews and prescriptions must continue with Psicon.\nWe advise GPs to consider their ability to take on a shared care arrangement with Psicon before initiating the referral and discussing this with their patient.\nReferral Options:\nYou can refer for an autism assessment, ADHD assessment or both.\nReferral Exclusions:\nWe are unable to accept referrals for patients who:\nHave co-morbid mental health or severe learning difficulties that significantly impair functioning and are likely to prevent a valid assessment from being conducted (e.g., inability to understand task instructions or hold conversations with the assessor).\nPose a risk to themselves or others.\nIf there is any uncertainty about the exclusion criteria, we strongly recommend discussing this with the\npatient beforehand to avoid potential disappointment should we later determine that our assessment\nis not appropriate for the individual.\nReferral Form Guidance:\nPlease ensure you have the client's personal email address to facilitate contact regarding the referral.\nContact Us:\nFor any questions or further clarification, please do not hesitate to reach out. Thank you for your understanding and cooperation.\n\u000f\nPsicon handle personal information in accordance with the Data Protection Act 2018 and the General Data Protection Regulations 2018. We will process personal information in ways that respects individual rights and in line with our company values, exercising the highest standards of confidentiality, integrity, and trust. For more information, please see the P\u0013 HYPERLINK \"https://www.psicon.co.uk/legal/privacy-policy\" \u0014rivacy Notice\u0015. You can also request a copy from one of our reception areas or by emailing \u0013 HYPERLINK \"mailto:enquiries@psicon.co.uk\" \u0014enquiries@psicon.co.uk\u0015\nPlease note that we are unable to backdate referrals. \u000bReferrals will be processed by the date this form is received to \u0013 HYPERLINK \"mailto:kmicb.psicon.adults@nhs.net\" \u0014kmicb.psicon.adults@nhs.net\u0015","cbCaie7jfVAlsONv","https://ap.wps.com/l/cbCaie7jfVAlsONv","docx",322980,8,"English","# Adult Right to Choose Referral Form\n## Eligibility and Assessment Options\n## ASD Assessment Pathway\n## ADHD Assessment Pathway\n## ADHD Medication and Shared Care Guidance\n## Referral Options and Exclusions\n## Referral Form Guidance and Submission","[{\"question\":\"Who is allowed to complete and sign this referral form?\",\"answer\":\"Only a GP should complete and sign the form.\"},{\"question\":\"What are the assessment options for adults in the ASD and ADHD pathways?\",\"answer\":\"Both pathways offer face-to-face assessments in Canterbury (Kent) and Basingstoke (Hampshire), and online assessments when clinically appropriate.\"},{\"question\":\"What happens after an ADHD diagnosis if medication is initiated through Psicon?\",\"answer\":\"After titration and stabilization, shared care with the patient’s GP is requested; if shared care is not possible, ongoing reviews and prescriptions continue with Psicon.\"}]","Adult Right to Choose - Referral Form - June 2025 | DOCX"]