Autism Health Access Project: Referral Form


The Autism Health Access Project is led by Leeds Autism AIM, part of The Advonet Group. It is a free service where we work with The Light Surgery and Leeds Student Medical Practice to improve access to healthcare services and address health inequalities for autistic people.

The service is open to autistic adults (aged 18 and over) who:
  • Are registered with either The Light Surgery or Leeds Student Medical Practice or;
  • Live in the catchment area for either of the above surgeries
  • Self-identify as autistic or have a diagnosis. If you would like support from our project, please fill in the form below and we will be in touch.
Confidentiality and consent

Leeds Autism AIM is part of The Advonet Group, a charity which provides independent advocacy. In order to support you, we may need to speak to other people. We will need your consent to this.

We will keep any information you give us safe within The Advonet Group or at the drop-in Hubs if you attend these. We keep information about who uses the service on our secure database and securely in paper files.

Any information you give us is kept confidential within The Advonet Group. We will only pass on information if you want to give your consent. The only exception to this is if you or someone else were at risk of harm.

1. Which GP surgery are you registered with? (must tick one of these) *


2. Your details *


3. Your contact details - if you do not want to be contacted by any of the below methods, please do not enter your details below. *


4. How would you like to initially be contacted? (Please tick all that apply)

We are offering a remote service, where we can offer appointments via email, phone, text chat or video call. *


5. Would you like us to contact someone else as well as or instead of you? *


6. If so, how do you know them?


7. Please leave their contact details below