Home to School Travel Assistance Form

Step 1 of 28

This form should be used to apply for SEN Home to School Travel Assistance. This service is for pupils who have special educational needs, disabilities or medical needs. Supporting evidence must be supplied with the application.

Travel Assistance is provided at the department’s discretion and if agreed, could be provided in any of the following ways:

- Independent Travel Training
- Personal Travel Budget (PTB)
- Seat on a Vehicle (Home Collection)
- Seat on a Vehicle (Collection Point)

Additional important information
It takes 4 weeks to process a completed application form and during this time it is the responsibility of parents and carers to transport their child to and from school. A completed application includes the supporting evidence. This department may visit applicants to assess their suitability for assistance using a partnership agency. If assistance is provided, please note that it is reviewed regularly and is subject to change.

Does your child use any other walking aids, e.g. walking frame, sticks, crutches, calipers, etc.?*

Yes

No
If yes, please specify*

Is your child able to walk a distance for approximately 5 minutes with or without accompaniment?*

Yes

No
If no, please evidence with further information*

Does your child need a car seat?*

Yes

No
Does your child need a booster seat?*

Yes

No
Does your child require lifting on & off the seat?*

Yes

No
If the answer is yes, parent/carer will be asked to assist their child on and off the vehicle seat.
Is your child able to fasten & unfasten their own seatbelt?*

Yes

No

Your Child's Needs, Language & Communication
Does your child have hearing difficulties i.e registered deaf or hearing impaired?*

Yes

No
Does your child have visual impairment, i.e. registered blind or partially sighted?*

Yes

No
How does your child communicate, i.e. verbally (if so, what language), signing, Makaton etc*

Does your child have emotional and behaviour difficulties?*

Yes

No
If yes, please explain how these are displayed*

Does your child have any fears that could affect/her on transport i.e. loud noises, colours, smells, Items of clothes, crowds etc.*

Yes

No
If yes, please describe*

If your child becomes anxious or distressed, what behaviour is displayed and how do you calm him/her?*

Does your child have physical or sensory difficulties?*

Yes

No
If yes, please give explain how your child displays this.*

Section 5: Medical Information
Does your child have epilepsy?*

Yes

No
Does your child have any other Medical needs that may affect transport, not previously mentioned e.g. requires oxygen, severe allergies, diabetes, etc. ?*

Yes

No
If yes to any of the above questions, please give details, e.g. what signs and symptoms do we need to look for or be aware of, and what action we need to take. Please be aware that our staff are not allowed to administer medications. If medications are required to be given we will call the emergency ambulance. Please provide a copy of any medical care plan or protocol that you have.*

Terms and Conditions for Transport:
THEFT, LOSS or DAMAGE OF PERSONAL BELONGINGS

We understand that at times, with discussion between the Home to School Travel Assistance Team and parents/carers, an item such as a toy or an iPad might be helpful to assist a young person on their journey. However, this must be with the understanding that the Travel Assistance Team cannot supervise the use of personal items. As such, parents will exercise responsibility in attending to and the safeguarding of all personal belongings placed on any SEND Home to School Transport. Leaving personal belongings such as laptops, iPads, valuables, textbooks, notes unattended even for short period of time, may invite unnecessary damage, thefts or create unnecessary misplacement or losses. The Council will not be held responsible for any personal loss or damage of such items.
Further transport guidance can be found using the following : link
Data Protection
Your personal information will be held and used in accordance with the requirements of the Data Protection Act 1998. We have a duty to protect the public funds we administer and may use the information you provide for the prevention and detection of fraud. We may also share this information with other bodies responsible for auditing or administering public funds for these purposes.
Declaration
Please tick the checkbox*
I declare that to the best of my knowledge the information I have given is correct and complete. I will inform the Special Educational Needs & Inclusion Services if any details I have given change. I agree that if transport assistance is agreed, the information I have given may be shared with Redbridge Transport Services to provide my child with safe and appropriate transport.

Home to School Travel Assistance Form

Section 1: Details of Child

Details of child

Details of child

School that you require transport to:

Section 2: Detail’s of Parent/Carer and family component (please inform this office if any of the information changes, after submission)

Detail’s of Parent/Carer

Detail’s of Parent/Carer

Emergency Contact details:

Additional Information

Section 4: Your Child's Personal Details

Your Child's Needs, Language & Communication

Section 5: Medical Information

Terms and Conditions for Transport:

Declaration