Get Respite Referral Form - Autism Sa - Autismsa Org

Filling out the respite referral form is an important step towards accessing necessary services for individuals with autism and their families. This guide will walk you through each section of the form, ensuring you provide all the required information accurately and efficiently.

Follow the steps to complete the form effectively.

1. Use the ‘Get Form’ button to obtain the form and open it for editing.
2. Indicate which respite program you are referring to by selecting either 'North' or 'South'.
3. Fill in the client details, including 'Family Name', 'Given Names', 'Address', 'Telephone', and 'Date of Birth'. Ensure all fields are completed accurately.
4. Specify the main language spoken at home and indicate if an interpreter is required by selecting 'Yes' or 'No'.
5. Indicate whether the child is registered with Autism SA and their eligibility for services from Disability SA by selecting the appropriate boxes.
6. Detail the child's diagnosis by selecting from the provided options, including Autism and Asperger Syndrome.
7. Answer questions regarding any challenging behaviors and their impact on family life. Provide details as necessary.
8. Note any additional information you feel is relevant to this referral, including support networks and any other pertinent circumstances.
9. Complete the referral section by identifying who the referral is being made by, and providing agency details if applicable.
10. Review your entries for accuracy and completeness. Once confirmed, you may save changes, download, print, or share the completed form.

Complete your Respite Referral Form online today to access vital support services.