Register with the Berkshire Adult Autism Support Service

    Thank you for your interest in registering for the NHS-funded Berkshire Adult Autism Support Service. Please can you answer some questions, so that we can best support you.




    Telephone number

    Email address


    Which council area do you live in? *

    If you answered Other above, please give the council name


    Do you have? *


    Do you currently receive any support? (please tick all that apply) *


    Details of professionals who support me (if applicable):


    Their job (eg social worker, NHS mental health professional, care agency worker, probation officer

    Telephone number

    Email address


    Message (if any)


    I consent to Autism Berkshire storing my details on a secure database and contacting me about (please tick all that apply)


    I am happy to be contacted by (please tick all that apply):

    Your confirmation:


    Privacy and data protection

    Personal information you submit using this form will be treated as confidential and stored securely. See our privacy policy for more information.