If this is a request for a particular team involvement, tick one box:
Previous Educational Setting(s)
- If child admitted during the past year, with admission dates
Support from other Professionals
Does the child / young person attend an SRB, or receive 'outreach' support from an SRB, Short Stay School for Norfolk or the School2School Support Service?
Please indicate other professionals / agencies who are currently / have been involved with the child / young person e.g. SALT, CAMHS, Paediatrician, Early Help, Social Care, and if there is any medical diagnosis
Has the Family Support Process been started?
Parent / Carer Consent
It is important that parents / Carers understand the reasons for making the request. We can only work with the child / young person with parent / carer understanding and consent.
The Educational Psychologist / Specialist Learning Support Teacher / Clinical Psychologist may:
- Talk to your child's teacher and other people who know your child well
- Observe your child in class
- Work with your child to complete some individual assessments
- Review Children's Services records for your child
I agree to this request for support by the Educational Psychology and Specialist Support Service. The contents of this form have been discussed with me.
I understand that i will be notified of the date of the appointmnt, I will have the opportunity to meet the professional and that i will receive written feedback about the outcomes of the consultation / assessment / intervention.
I understand that information from the consultation / assessment may also be shared or discussed with other professional services if that is in the best interests of my child, and will be stored securely for future reference.
Where child has sufficient understanding:
I have discussed the reason for making this request with my child
Please leave this blank