Redbridge e-forms SENDATS Privacy policy Please read the Children’s Services privacy notice to know about how we will use your information. Reason for referralPlease select the reason for your referral(Required) SENDATS: SEND Advisory Support SENDATS: Training Request SENDATS: Home Tuition Referrals SENDATS: Exceptional Request SENDATS: Therapeutic Intervention Request Download the SENDATS permission form Please note that tuition requests made to the local authority must meet specific criteria as outlined in the Medical Inclusion Tuition Policy. Please refer to this before completing a referral. SENDATS Medical Inclusion Tuition Policy June 2024 SENDATS: Therapeutic Intervention Support Parent Consent Form SENDATS CAPT-TI Practitioner School Agreement By completing this referral, you are agreeing to the availability of an ongoing designated therapeutic space for the duration of the intervention. Please liaise with the SENDATS therapeutic practitioner, agreeing an appropriate designated space prior to the start of the intervention, mitigating against potential risk factors and interruptions, ensuring consistency of a safe, well-boundaried space- same time, same duration, same room. SEND Advisory Support - Pupil InformationSENDATS: Home Tuition- Pupil InformationSENDATS: Exceptional Request - Pupil InformationSENDATS: Training Request - Details of ReferrerSENDATS: Therapeutic Intervention Support - Details of ReferrerName(Required)Date of birth(Required) Day Month Year Role(Required)School(Required)School / Service(Required)Education Setting Address e.g. school/home(Required)Year group(Required)Home address(Required) Address Line 1 Address Line 2 City AberdeenshireAngus/ForfarshireArgyllshireAyrshireBanffshireBedfordshireBerkshireBerwickshireBlaenau GwentBridgendBuckinghamshireButeshireCaerphillyCaithnessCambridgeshireCardiffCarmarthenshireCeredigionCheshireClackmannanshireConwyCornwallCromartyshireCumberlandDenbighshireDerbyshireDevonDorsetDumfriesshireDunbartonshire/DumbartonshireDurhamEast Lothian/HaddingtonshireEssexFifeFlintshireGloucestershireGwyneddHampshireHerefordshireHertfordshireHuntingdonshireInverness-shireIsle of AngleseyKentKincardineshireKinross-shireKirkcudbrightshireLanarkshireLancashireLeicestershireLincolnshireLondonMerthyr TydfilMiddlesexMidlothian/EdinburghshireMonmouthshireMorayshireNairnshireNeath Port TalbotNewportNorfolkNorthamptonshireNorthumberlandNottinghamshireOrkneyOxfordshirePeeblesshirePembrokeshirePerthshirePowysRenfrewshireRhondda Cynon TaffRoss-shireRoxburghshireRutlandSelkirkshireShetlandShropshireSomersetStaffordshireStirlingshireSuffolkSurreySussexSutherlandSwanseaTorfaenVale of GlamorganWarwickshireWest Lothian/LinlithgowshireWestmorlandWigtownshireWiltshireWorcestershireWrexhamYorkshire County Postcode Phone number(Required)Parent email(Required) Referrer email (training)(Required) Email Address(Required) Parent contact number(Required)Phone number(Required)Confirm this child is an LBR resident(Required) Yes No ReligionEthnicityBirth Gender Male Female Prefer not to say SEND(Required)Choose an itemNo SENDSEND SupportEHC Needs Assessment in processEHCPEAL(Required)Choose an itemNoEAL Stage A - New to EnglishEAL Stage B - Early AcquisitionEAL Stage C - Developing CompetenceEAL Stage D - CompetentEAL Stage E - FluentLanguage spoken at home(Required)Interpreter required(Required) Yes No Social Care status(Required)Choose an itemNot ApplicableCIN - Child in NeedCP - Child ProtectionEarly Intervention Support / Families Together HubCLA - Child who is looked afterSGO - special guardianship orderPost CLA / Post AdoptionPlease provide contact details for virtual school(Required) SENDATS: Home Tuition- Pupil InformationPupil UPN number(Required)Is this pupil in secondary school?(Required) Yes No Pupil UCI number(Required)Attendance figures for the current term(Required)Attendance figures for the current year(Required)Is the pupil's non attendance at school marked as authorised or unauthorised?(Required) authorised unauthorised Is the school EWO involved in the case?(Required) Yes No Contact details of the school EWO(Required) SENDATS: Home Tuition- Pupil InformationMost recent maths assessment data score(Required) working below working towards working at working above Most recent maths standardised score(Required)Most recent English assessment data score(Required) working below working towards working at working above Most recent English standardised score(Required)Most recent science assessment data score(Required) working below working towards working at working above Most recent science standardised score(Required)What are the pupil's current maths targets?(Required)What are the pupil's current English targets?(Required)What are the pupil's current science targets?(Required)Is pupil in KS4?(Required) Yes No Which exam board are they sitting for maths?(Required)Which exam board are they sitting for English?(Required)Which exam board are they sitting for science?(Required) SENDATS: Therapeutic Intervention Support - Student DetailsFirst name(Required)Last name(Required)Date of birth(Required) Day Month Year School Year group(Required)Does the student live in Redbridge(Required) Yes No Please enter the postcode and click on Find address(Required)Please select Find addressSelected address Address(Required) Address Line 1 Address Line 2 City AberdeenshireAngus/ForfarshireArgyllshireAyrshireBanffshireBedfordshireBerkshireBerwickshireBlaenau GwentBridgendBuckinghamshireButeshireCaerphillyCaithnessCambridgeshireCardiffCarmarthenshireCeredigionCheshireClackmannanshireConwyCornwallCromartyshireCumberlandDenbighshireDerbyshireDevonDorsetDumfriesshireDunbartonshire/DumbartonshireDurhamEast Lothian/HaddingtonshireEssexFifeFlintshireGloucestershireGwyneddHampshireHerefordshireHertfordshireHuntingdonshireInverness-shireIsle of AngleseyKentKincardineshireKinross-shireKirkcudbrightshireLanarkshireLancashireLeicestershireLincolnshireLondonMerthyr TydfilMiddlesexMidlothian/EdinburghshireMonmouthshireMorayshireNairnshireNeath Port TalbotNewportNorfolkNorthamptonshireNorthumberlandNottinghamshireOrkneyOxfordshirePeeblesshirePembrokeshirePerthshirePowysRenfrewshireRhondda Cynon TaffRoss-shireRoxburghshireRutlandSelkirkshireShetlandShropshireSomersetStaffordshireStirlingshireSuffolkSurreySussexSutherlandSwanseaTorfaenVale of GlamorganWarwickshireWest Lothian/LinlithgowshireWestmorlandWigtownshireWiltshireWorcestershireWrexhamYorkshire County Postcode Parent(s)/Carer Email address(Required) Parent(s)/Carer Phone number(Required)Who has parental responsibility(Required)First language(Required)ReligionEthnicityAttendance in education provisionKnown to SENDATS Yes No SENDATS: Therapeutic Intervention Support - Background InformationDetails of significant life event(s), key traumatic event(s) and adverse childhood experiencesDetails of mental health diagnosis (if appropriate)Details of medical condition(s)Details of medication(s) SENDATS: Therapeutic Intervention Support - Background Information contd...Is the student receiving ongoing medical intervention Yes No Temporary housing Yes No Refugee/Asylum seeker Yes No Parent and/or sibling-in-need Yes No Positive/trusting relationship with at least one adult Yes No NameRoleSuspension(s) and/or permanent exclusionsSuspension(s) and/or permanent exclusions Yes No Number of suspension(s)Permanent exclusions Yes No SENDATS: Therapeutic Intervention Support - Other Services InvolvementPrevious Counselling/Psychotherapy (when, for how long, what type, briefly for what)EWMHSCurrent Yes No Previous Yes No Waiting Yes No Educational Psychologist/MHSTIndividual Yes No Group Yes No Whole School Yes No Social CareCLA Yes No CIN Yes No CP Yes No SGO Yes No Special Educational Needs/DisabilityPAON Yes No Additional Yes No EHCP Yes No Please upload current EHCPMax. file size: 50 MB. Additional Cognition and Learning Social interaction & communication Social Emotional Mental Health (SEMH) Physical Disabilities Visual Impairment Deafness Complex Medical Needs Multi-sensory Impairment PAON Cognition and Learning Social Interaction & Communication Social Emotional Mental Health (SEMH) Physical Disabilities Visual Impairment Deafness Complex Medical Needs Multi-sensory Impairment SENDATS: Therapeutic Intervention Support - Other Services InvolvementEnglish Additional Language Yes No Level No EAL Stage A - New to English EAL Stage B - Early Acquisition EAL Stage C - Developing Competence EAL Stage D - Developing Competence EAL Stage E - Fluent Speech & Language/CommunicationWould benefit from non-verbal therapeutic intervention? Yes No Home TuitionMedical Yes No Non-Medical Yes No Therapeutic Intervention Support - Level of Experience of Presenting Need(s)Reason for Referral Level of need for Depression Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Anxiety/Stress Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Inner Conflict Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Interpersonal Conflict Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Eating Disorder Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Addiction Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Physical Symptoms Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Trauma Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Bereavement/Loss Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Self-esteem Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Academic Working Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Identity Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd....Level of need for Bullying/Bullied Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Level of need for Other Not Sure Mild Moderate Severe Duration of need Less than 6 months 6-12 months More than 12 months Recurring Prolonged Further Details on Reason for Referral Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd...Suicide (attempt) Yes No Further InformationSuicidal (ideation) Yes No Further Information Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd...Self-harm Yes No Further InformationHarm to Others Yes No Further Information Therapeutic Intervention Support - Level of Experience of Presenting Need(s) contd...Safety Plan in Place? Yes No Is there a Current Risk Assessment? Yes No Please upload the current risk assessmentMax. file size: 50 MB. Further Information Therapeutic Intervention Support - Document upload Parent Consent Form SENDATS CAPT-TI Practitioner School Agreement Please upload Parent(s)/carer(s) consent form hereMax. file size: 50 MB. Please upload the SENDATS CAPT-TI Practitioner School Agreement hereMax. file size: 50 MB. SEND Advisory Support - Pupil Information further detailsHas this child recently moved to your setting(Required) Yes No Not applicable Previous education provider (if relevant) SENDATS: Training Request - Training request Please refer to our training brochure (opens in new window) before selecting from the following drop-down Please select a maximum of 3 training sessions. Please visit https://linktr.ee/seatss for further events for parents and schools. Training Session/s Request 1(Required)Please selectAn introduction to Phonics & Developing Reading Fluency (Secondary only)Developing reading and spelling skillsColourful Semantics as a whole-class approachStrategies to Support Executive Function in KS2 and Secondary Level (small group training)Adaptive Teaching Ambassadors: A Mindset for Every Classroom (cluster group training – see dates on brochure)Supporting children with maths difficulties/dyscalculiaIntroduction to Zones of Regulation – please note schools will need to purchase the ZOR programme before introductory trainingDeveloping friendships & strategies to support communicationDeveloping focus & attention skills (Trauma & SEMH focus)SEMH whole-school project (waiting list only)15-minute specialist morning briefings (AS focus)Pathological Demand AvoidanceUnderstanding behaviour (AS focus)Intensive interaction training for LSAsMakaton introductionSensory circuitsSupporting pupils working below NC levelsSupporting SEMH Needs through Universal Strategies (waiting list)Positive Handling Training (separate registration)BSL basicsDeaf awarenessVI awareness trainingSighted Guide TrainingBecome a School Motor Skills Ambassador (separate registration)SENDATS Introductory Parent Coffee MorningsAPTGO SEND Audit (commissioned)SENDATS School SEND Audit (Commissioned)Autism Education Trust training (waiting List)Training Session/s Request 2Please selectAn introduction to Phonics & Developing Reading Fluency (Secondary only)Developing reading and spelling skillsColourful Semantics as a whole-class approachStrategies to Support Executive Function in KS2 and Secondary Level (small group training)Adaptive Teaching Ambassadors: A Mindset for Every Classroom (cluster group training – see dates on brochure)Supporting children with maths difficulties/dyscalculiaIntroduction to Zones of Regulation – please note schools will need to purchase the ZOR programme before introductory trainingDeveloping friendships & strategies to support communicationDeveloping focus & attention skills (Trauma & SEMH focus)SEMH whole-school project (waiting list only)15-minute specialist morning briefings (AS focus)Pathological Demand AvoidanceUnderstanding behaviour (AS focus)Intensive interaction training for LSAsMakaton introductionSensory circuitsSupporting pupils working below NC levelsSupporting SEMH Needs through Universal Strategies (waiting list)Positive Handling Training (separate registration)BSL basicsDeaf awarenessVI awareness trainingSighted Guide TrainingBecome a School Motor Skills Ambassador (separate registration)SENDATS Introductory Parent Coffee MorningsAPTGO SEND Audit (commissioned)SENDATS School SEND Audit (Commissioned)Autism Education Trust training (waiting List)Training Session/s Request 3Please selectAn introduction to Phonics & Developing Reading Fluency (Secondary only)Developing reading and spelling skillsColourful Semantics as a whole-class approachStrategies to Support Executive Function in KS2 and Secondary Level (small group training)Adaptive Teaching Ambassadors: A Mindset for Every Classroom (cluster group training – see dates on brochure)Supporting children with maths difficulties/dyscalculiaIntroduction to Zones of Regulation – please note schools will need to purchase the ZOR programme before introductory trainingDeveloping friendships & strategies to support communicationDeveloping focus & attention skills (Trauma & SEMH focus)SEMH whole-school project (waiting list only)15-minute specialist morning briefings (AS focus)Pathological Demand AvoidanceUnderstanding behaviour (AS focus)Intensive interaction training for LSAsMakaton introductionSensory circuitsSupporting pupils working below NC levelsSupporting SEMH Needs through Universal Strategies (waiting list)Positive Handling Training (separate registration)BSL basicsDeaf awarenessVI awareness trainingSighted Guide TrainingBecome a School Motor Skills Ambassador (separate registration)SENDATS Introductory Parent Coffee MorningsAPTGO SEND Audit (commissioned)SENDATS School SEND Audit (Commissioned)Autism Education Trust training (waiting List) SENDATS: Training Request - Details of training sessionDate/s requested - please provide alternatives if possible – minimum of 4 weeks’ notice required – please note, flexibility around training dates is required(Required) Please use "+" plus icon to add a new alternative date Add RemoveTime available for session/s to be delivered (in hours/mins)(Required)Time of the day for training to take place(Required)For example 4PMNumber of participants(Required)Please enter a number greater than or equal to 1.Role of participants(Required) Leadership Teaching Staff Support Staff Parents/Carers Will the room provided have appropriate ICT facilities ?(Required) (e.g. presenting capabilities with audio) SEND Advisory Support - Referral detailsSENDATS Home Tuition - Referral detailsReason for Referral(Required) Check all that apply Single visit and advice Full Initial Assessment Advice/training to implement current EHCP provision Reason for Referral(Required) Check all that apply MEDICAL tuition – student is unable to attend school due to physical health or mental health needs NON-MEDICAL tuition – student has been excluded from school and requires immediate education offer NON-MEDICAL tuition – student is at risk of being excluded NON-MEDICAL tuition – EHCP student awaiting specialist placement (must be agreed by Head of SEND) SEND Advisory Support - Areas of needPrimary area of need(Required)Choose an itemCognition and LearningLanguage and CommunicationAutism SpectrumSocial CommunicationPhysical DisabilityVisual ImpairmentDeafness / Hearing LossComplex Medical NeedsSocial Emotional & Mental Health NeedsBehaviour that challengesAdditional area of needChoose an itemCognition and LearningLanguage and CommunicationAutism SpectrumSocial CommunicationPhysical DisabilityVisual ImpairmentDeafness / Hearing LossComplex Medical NeedsSocial Emotional & Mental Health NeedsBehaviour that challengesAdditional area of needChoose an itemCognition and LearningLanguage and CommunicationAutism SpectrumSocial CommunicationPhysical DisabilityVisual ImpairmentDeafness / Hearing LossComplex Medical NeedsSocial Emotional & Mental Health NeedsBehaviour that challenges SEND Advisory Support - Pupil further informationWhat are the current needs of the pupil and what support/provision has been implemented so far(Required)Please list the universal strategies and interventions currently in place(Required)Upload provision map and APDR cycle/s Drop files here or Select files Accepted file types: gif, svg, jpg, jpeg, png, pdf, doc, docx, xls, xlsx, csv, txt, Max. file size: 50 MB. SEND Advisory Support - Current attainment levelsMaths(Required)English - reading(Required)English - writing(Required)Current attendance percentage(Required)If the student is persistently absent please outline what steps have been taken to address thisHas this child had any fixed term exclusions(Required) Yes No Please provide details(Required)What do you hope to get from this referral? What impact do you anticipate this support will have?(Required) SENDATS: Training Request - Planning training request further details Please provide any further details to help us with planning your training request(Required) SENDATS: Training Request - Training request further detailsPlease give us more information about this training request including where this fits with your school provision, school development plan or APDR?(Required) SENDATS: Training Request - Recent training detailsHas your school had any other recent training (from SENDATS, in school, other providers)?(Required) Yes No Please provide a brief summary SENDATS Home Tuition - Student's current needsCurrent Needs(Required) Please Provide a Summary of the student’s current needs which are impacting on school attendance SENDATS Home Tuition - Support and provision detailsSupport and provision(Required) Please provide a summary of what support has been implemented by stakeholders over time to meet this student’s needs, including what educational offer has been provided by the school during the student’s absence SEND Advisory Support - Services involved detailsSENDATS Home Tuition - Services involved detailsServices involved with student/family(Required) Specialist Medical Services (e.g. GOSH) Audiology Ophthalmology Children’s Development Centre (CDC) EWMHS (CAMHS) Education Welfare Service NELFT therapies Redbridge therapies Educational Psychologist MHST / REWT Social Care Mentoring Not applicable Other Please specify(Required)Services involved with student/family(Required) Specialist Medical Services (e.g. GOSH) EWMHS (CAMHS) Education Welfare Service YOTPS Educational Psychologist Families Together Hub Social Worker SENDATS Advisory support MHST / REWT CAF Team Mentoring Not applicable Other Please specify(Required) SEND Advisory Support - Parental viewsSENDATS: Home Tuition - Parental viewsParental views on Referral(Required) SEND Advisory Support - Student viewsSENDATS: Home Tuition - Student viewsStudent views on Referral(Required)Please write N/A if the child is under school age SEND Advisory Support - Checklist of Supporting Evidence SEaTSS Parental Permissions Form – referrals will not be accepted without a signed consent form Evidence of universal strategies / reasonable adjustments in place Evidence of Assess Plan Do Review (at least one cycle) Relevant diagnostic/medical/professional reports if applicable SENDATS Home Tuition - Checklist of Supporting Evidence SEaTSS Parental Permissions Form – referrals will not be accepted without a signed consent form Latest school report including current academic levels Current attendance Overview Medical Referrals Individual Health Care Plan Recent Specialist Medical Evidence: specialist consultant, CAMHS, etc (please refer to MI Tuition policy for more detail on acceptable evidence) Non-Medical Referrals: Exclusions School Behavioural/Pastoral support plan Individual risk assessment Evidence of school-based support over time (for example Assess-Plan-Do-Review) Evidence of collaboration with relevant services/agencies (e.g. mentoring, EPS, Social Care) as appropriate Non-Medical Referrals: SEND Education Health and Care Plan Evidence of SEND panel agreement to consult specialist placements Details of consultation dates and next SEND panel date SENDATS: Exceptional Request - Checklist of Supporting Evidence SEaTSS Parental Permissions Form – referrals will not be accepted without a signed consent form Please upload supporting evidence and permissions(Required) Drop files here or Select files Accepted file types: gif, svg, jpg, jpeg, png, pdf, doc, docx, xls, xlsx, csv, txt, Max. file size: 50 MB. Please upload completed Parents Permission form(Required)Accepted file types: gif, svg, jpg, jpeg, png, pdf, doc, docx, xls, xlsx, csv, txt, Max. file size: 50 MB. SENDATS: Exceptional Request - Details of requestWhat do you request?(Required) Advisory Teacher Consultation HTLA Support SEN Audit / Special Project IT / Equipment Assessment Technical Support Other Please state(Required)Requested start date(Required)Please outline the nature of your request and why are you requesting exceptional support(Required)e.g transition support; child at risk of exclusion; staff training, alternative recommendation/strategies; parent support; Support for Home or School; support to implement outcomes from EHCP's; Child awaiting placement for specialist provisionPlease share all available information including:Attendance data; assessment data; number and type of exclusions where relevant; strategies trialled if relevant; involvement of other professionals including CWDT, Social Care, Health, etc. (please attachments most up to date reports available).Please upload any additional documentation if applicable Drop files here or Select files Accepted file types: gif, svg, jpg, jpeg, png, pdf, doc, docx, xls, xlsx, csv, txt, Max. file size: 50 MB. SEND Advisory Support - Details of ReferrerSENDATS Home Tuition - Details of ReferrerSENDATS: Exceptional Request - Details of ReferrerThis field is hidden when viewing the formDetails of ReferrerName(Required)Role(Required)School / Service(Required)Phone Number(Required)Referrer email(Required) Name of key contact for ongoing liaison with SENDATS Tuition Team (if different)
