My Medical Appointment / Reason For Today’s Visit

This is a tool for individuals with ASD and their parents/caregivers to use at each appointment with a health care professional to improve the quality of each visit. The Word version can be customized or the PDF version can be submitted electronically.

My Medical Appointment / Reason For Today’s Visit

My Medical Appointment / Reason For Today’s Visit 150 150 York Community Autism Partnership

Customizable Word Version

Download Fillable PDF

Customizable French Word Version

Let's get started.

York ASD Partnership logo

Send this message to:

[pbvariable selector=".contactEducation" attribute="data-recipient"]
[pbvariable selector=".contactEducation" attribute="data-email"]





    Let's get started.

    York ASD Partnership logo

    Send this message to:

    [pbvariable selector=".contactEducation" attribute="data-recipient"]
    [pbvariable selector=".contactEducation" attribute="data-email"]





      Thank you for your feedback.

      York ASD Partnership logo

      Send this message to:

      Neil Walker
      neil.walker@yorkcommunityautismpartnership.org





        Thank you for your feedback.

        York ASD Partnership logo

        Send this message to:

        Neil Walker
        neil.walker@yorkcommunityautismpartnership.org





          Let's talk about it.

          York ASD Partnership logo

          Send this message to:

          Neil Walker
          neil.walker@yorkcommunityautismpartnership.org





            Let's talk about it.

            York ASD Partnership logo

            Send this message to:

            Neil Walker
            neil.walker@yorkcommunityautismpartnership.org





              Skip to content