The Butterfly Room
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 comfortable Making A Referral
To make a referral, including self referrals, to The Butterfly Room please complete the appropriate referral form below:

Therapy Referrals

Self Referrals 

Please book your free initial consultation call and complete and return your Therapy referral form and Questionnaire to [email protected]. Please ensure you send your referral form and questionnaire to us prior to your scheduled consultation call.

Adult Self Referrals 
Please book your free initial consultation call and complete and return your Therapy referral form to [email protected]. Please ensure you send your referral form to us prior to your scheduled consultation call.

Local Authority/Educational Institutions
Therapy referral form - if you are referring from a local authority, service or an educational institute, please fully complete and return your referral form to [email protected] and a member of our team will contact you directly to progress. 

Diagnostic Referrals
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ASD Screening Assessment - Please book your free initial consultation call and complete and return the relevant diagnostics referral form -

Child Diagnostic Referral Form 
Adult Diagnostics Referral Form

Please ensure you return your completed referral form to [email protected] prior to your scheduled consultation call.


Please ensure that you have read and understood our policies and procedures, at the bottom of this page. 

What Happens Next?
Once you have booked your initial consultation call and have sent us your completed referral form. You will be contacted on the day and time that you have booked your call, on the number you have provided.  This consultation will involve obtaining relevant back history, discussing current concerns and allocating the most appropriate therapy and therapist to support your child and your family.

Once this initial consultation is complete, depending on your flexibility and current availability you will be placed on to the most appropriate waiting list and we will contact you as soon as a suitable appointment becomes available.  We will do our best to give you an indication of any wait times, should there be one, on your consultation call. 

Once your sessions begin, your child will enter the space and we do ask that parents/carers remain at the centre whilst sessions take place, and parents/carers can wait in our comfortable waiting room. Your therapist will regularly assess your child's progress and will be able to give you an initial update around session 6, you will receive further information regarding reviews/feedback in your welcome pack once your appointment slot has been confirmed. 

It is important that parents do not off load to the therapist in front of their child as this can be detrimental to the relationship between the therapist and child. If you feel you need a meeting with your child's therapist to discuss any on going issues, then you can arrange this with your therapist, and of course keep us updated via email as you need too.

By attending therapy session(s), assessment(s) and diagnostic clinic(s) you are confirming that you have read, and agree to adhere to, The Butterfly Room terms and conditions, policies, and procedures -
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​Therapy Terms and Conditions 
ASD Diagnostic Clinic Terms and Conditions 
ASD Diagnostic Payment Terms and Conditions

​Complaints Procedure
Privacy Policy
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  • Home
  • About
  • Therapy Services
  • ASD Screening Assessments
  • Diagnostic Clinic
  • Contact
  • MEET THE TEAM
  • Making A Referral & Policies
  • Covid -19
  • Q&A
  • Signposting