Leeds Autism AIM - New referral

1. About you

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Leeds Autism AIM       
 
Due to the Coronavirus outbreak, we are making some temporary changes to how the Leeds Autism AIM service works. We are still able to provide one-to-one advocacy, peer support, information and signposting services remotely. 

If you have an issue that you would like us to help you with, please fill in the form below. If you are a professional, please consult with your client before filling in this form.

We will use the details you give us to get back to you and then book an appointment with you. We will not use this information for anything else and will store your information securely. 

Please note that Leeds Autism AIM do not provide support workers or personal assistants. We also don’t have case workers assigned to specific people. Please also note that our services are for autistic adults living in Leeds (aged 18+).

Sometimes, we will work with a 17-year-old as they transition into adulthood to let them know what services are available once they turn 18.
Leeds Autism AIM does provide low level short-term advocacy, peer support, mentoring and post-diagnostic support, self-advocacy resources, information and signposting. 
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. Your details

(Please note that we only work with autistic adults who live or are registered with a GP in the Leeds City Council area): Map of Leeds *

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2. Do you have an autism diagnosis? If you or the person you are referring don't have one, but are seeking a diagnosis, you/they can still join our groups. *

 

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. You must enter at least one form of contact, so we can get in touch with you. *

 

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 instead of you?

 

6. If so, how do you know them?

 

7. Please leave their contact details below

 
If you would like to communicate with us via instant messaging, audio call or video call and don't know how to use or access them, we will send on some instructions for how to use those tools.