PIFU form

Children’s Speech and Language Therapy Service

Patient Initiated Follow Up (PIFU) Form

If your child’s care plan says they are on a Patient Initiated Follow Up, you can use this form to request a review.

Please check the date that PIFU runs out on the child’s care plan.

If this date has passed, the child will have been discharged and you will need to request a new referral. This can be done using the form on this webpage: https://www.nlg.nhs.uk/services/speech-language-children/nlincs/

If you are not sure about the PIFU end date or need another copy of the care plan, please contact us on 01724 203755 or email [email protected]

FAQs

Who can complete this form?
Parents, carers, setting and school staff. If you are a setting or school, please ensure you have parent consent.

When can you complete this form?
When the short term target/s have been achieved but concerns remain and new targets are needed, or when there are difficulties working on the agreed targets and more support is needed.

Do I have to use the online form?
No, you can contact the department and ask to speak to a member of our team.

What if I can’t answer all the questions on the form?
Work with a colleague or professional who is able to answer the questions (e.g. the person working with the child on their targets).

What happens after I’ve filled in the form?
You will receive a notification to confirm that the request has been submitted. The information you provide will be triaged and we will contact you on the telephone number or email address you give to let you know what happens next.

If you have any further questions, please contact the service on 01724 203755 or [email protected]

We need consent from a parent or person with Parental Responsibility before we can accept this request. Please gain consent and then complete the form, or contact us on 01724 203755 for advice.