Referral Form
Submitted 4 mins ago
Via palmerandpalmer.co.uk
Read-only — submitted form. All data imported automatically.
1 About You
Yes
No
2 The Person Being Referred
Yes
No
3 Neuro-affirmative
Yes
No
Use of diagnosis
Cognitive descriptors
Person-first language
✓ Identity-first language
Use of typology
✓ Emotional descriptors
4 Your Request
✓ Assessment
Psycho-legal
Therapy
Organisation
Other
Yes
No
Yes
No
Search engine
✓ Word of mouth
Online ad
Happy to receive PAPPS news & updates
✓ I have read and agree to the terms & conditions.
Submitted: 25 April 2026 at 09:14:22 · Via palmerandpalmer.co.uk/refer-now/
Auto-Created Case Record
NEW
Created instantly
Case #2053 Created
Client Name
Liam Okafor
Date of Birth
14 Aug 2015 (age 10)
Case Type
Comprehensive Assessment
Date Created
25 April 2026
Referrer
Mrs D. Osei
Organisation
Broadland Learning Trust
Current Status
New — Awaiting Discovery Call
Automated Activity Log
Today — 25 April 2026
09:14
Referral form received from Mrs D. Osei, Broadland Learning Trust — via palmerandpalmer.co.uk/referral
09:14
Case #2053 created automatically — Liam Okafor, Comprehensive Assessment. All referral data imported with no manual entry.
09:14
Discovery call task assigned to Sarah Miller — due within 3 working days per intake SLA.
09:14
Confirmation email sent to Mrs D. Osei — acknowledging referral receipt and outlining next steps.