ADHD & Autism Adjustment Letter Request
Submit your details, assessment information, and supporting documents to request a workplace or education adjustment letter.
Patient Details
Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Telephone Number
*
-
Area Code
Phone Number
Assessment Details
Condition assessed
*
ADHD
Autism
Combined ADHD & Autism
Assessment date
-
Month
-
Day
Year
Date
Letter Recipient and Purpose
Who is the letter for?
*
Employer
University
College
School
Apprenticeship
Other
Name of organisation
*
Name of School, University or place of work
Job title or course name
Brief explanation of what the letter is required for
*
Adjustments you would like the letter to consider
Supporting Documents and Declaration
Supporting documents
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Declaration
*
I confirm that the information provided is accurate and complete.
My Products
prev
next
( X )
Standard Adjustment Letter
£50.00
£
50.00
Payment Methods
Debit or Credit Card
Klarna
Submit request
Should be Empty: