[Your address]
[City, Postcode]
[Date]

[GP Practice name]
[GP Practice address]

Re: Request for Right to Choose referral

Dear Doctor,

I am writing to request a referral for an [ADHD / Autism / ADHD and Autism] assessment under the NHS Right to Choose framework.

Under the NHS Constitution and the Patient Choice framework (NHS England), patients in England have a legal right to choose any qualified provider for a first outpatient mental health appointment. This includes ADHD and autism assessment services, where the chosen provider holds an NHS contract or AQP framework agreement.

I would like to be referred to:
  [Clinic name]
  [Clinic website]

This provider is NHS-commissioned and offers [ADHD / Autism] assessment services via Right to Choose. They will accept referrals directly from a GP.

My details:
  Full name: [Your full name]
  Date of birth: [DD Month YYYY]
  NHS number (if known): [NHS number]

Please make the referral at your earliest convenience. The provider can supply a referral template if needed.

Thank you for your help.

Yours sincerely,

[Your full name]

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