Information on Self-referring for Parents

For further information please refer to the Information leaflet in the downloads below.

To submit a referral please complete the relevant online form (see below). Once completed click on send and your form will automatically be sent to us.

If you would prefer a referral form to be sent to you by post please contact us via the Contact Us page or call us on 0121 777 9873. Once completed, return by post to the address given on the form. Alternatively you can use our email facility with document upload on the Contact Us page.

For further details of the referral process, please refer to How to set up contact for your child on the NACCC website at  You may download the NACCC fact sheetService delivery flowcharts from the inset that appears towards the top of the webpage on the right hand side or the PDF at the bottom of the page.

Please do not hesitate to call us. We are here to help and to answer any questions you may have.

Before completing the form, please read our Privacy Statement. At the end of the self-referral-form you will be signing to confirm you have read and understood our Privacy Statement. The information you provide to us is confidential. We do not disclose any details to the other party without your consent.

Online Referral Form

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