Redbridge e-forms

SENDATS

Please 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

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 Information

SENDATS: Home Tuition- Pupil Information

SENDATS: Exceptional Request - Pupil Information

SENDATS: Training Request - Details of Referrer

SENDATS: Therapeutic Intervention Support - Details of Referrer

First name(Required)

Last name(Required)

Date of birth(Required)

Day

Month

Year

SEND Advisory Support - Pupil Information

SENDATS: Home Tuition- Pupil Information

SENDATS: Exceptional Request - Pupil Information

SENDATS: Training Request - Details of Referrer

SENDATS: Therapeutic Intervention Support - Details of Referrer

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 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

SEND Advisory Support - Pupil Information

SENDATS: Home Tuition- Pupil Information

SENDATS: Exceptional Request - Pupil Information

Religion

Ethnicity

Birth Gender

Male

Female

Prefer not to say

SEND(Required)

EAL(Required)

Language spoken at home(Required)

Interpreter required(Required)

Yes

Social Care status(Required)

Please provide contact details for virtual school(Required)

SENDATS: Home Tuition- Pupil Information

Pupil UPN number(Required)

Is this pupil in secondary school?(Required)

Yes

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

Contact details of the school EWO(Required)

SENDATS: Home Tuition- Pupil Information

Most 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)

SENDATS: Home Tuition- Pupil Information

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)

SENDATS: Home Tuition- Pupil Information

Is pupil in KS4?(Required)

Yes

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 Details

First name(Required)

Last name(Required)

Date of birth(Required)

Day

Month

Year

School Year group(Required)

SENDATS: Therapeutic Intervention Support - Student Details

Does the student live in Redbridge(Required)

Yes

Please enter the postcode and click on Find address(Required)

Please select

Find addressSelected address

Address(Required)

Address Line 1 Address Line 2 City County Postcode

Parent(s)/Carer Email address(Required)

Parent(s)/Carer Phone number(Required)

Who has parental responsibility(Required)

SENDATS: Therapeutic Intervention Support - Student Details

First language(Required)

Religion

Ethnicity

Attendance in education provision

Known to SENDATS

Yes

SENDATS: Therapeutic Intervention Support - Background Information

Details of significant life event(s), key traumatic event(s) and adverse childhood experiences

Details of mental health diagnosis (if appropriate)

Details of medical condition(s)

Details of medication(s)

SENDATS: Therapeutic Intervention Support - Background Information

Is the student receiving ongoing medical intervention

Yes

Temporary housing

Yes

Refugee/Asylum seeker

Yes

Parent and/or sibling-in-need

Yes

SENDATS: Therapeutic Intervention Support - Background Information

Positive/trusting relationship with at least one adult

Yes

Name

Role

SENDATS: Therapeutic Intervention Support - Background Information

Suspension(s) and/or permanent exclusions

Yes

Number of suspension(s)

Permanent exclusions

Yes

SENDATS: Therapeutic Intervention Support - Other Services Involvement

Previous Counselling/Psychotherapy (when, for how long, what type, briefly for what)

EWMHS

Current	Previous	Waiting	Actions

There are no Entries.

Maximum number of entries reached.

Educational Psychologist/MHST

Individual	Group	Whole school	Actions

There are no Entries.

Maximum number of entries reached.

Social Care

CLA	CIN	CP	SGO	Actions

There are no Entries.

Maximum number of entries reached.

Special Educational Needs/Disability

PAON	Additional	EHCP	Actions

There are no Entries.

Maximum number of entries reached.

SENDATS: Therapeutic Intervention Support - Other Services Involvement

English Additional Language

Yes

Level

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 and Language/Communication

Would benefit from non-verbal therapeutic intervention?

Yes

Home tuition - Medical

Yes

Home tuition - Non medical

Yes

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Reason for referral - Depression

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Anxiety/Stress

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Inner conflict

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Interpersonal conflict

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Reason for referral - Eating disorder

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Addiction

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Physical symptoms

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Trauma

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Reason for referral - Bereavement/Loss

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Self-esteem

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Academic working

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Identity

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Reason for referral - Bullying/Bullied

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Reason for referral - Other

Level of need	Duration of need	Actions

There are no Entries.

Maximum number of entries reached.

Further details on reason for referral

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Suicide (attempt)

Yes

Further Information

Suicidal (ideation)

Yes

Further Information

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Self-harm

Yes

Further Information

Harm to Others

Yes

Further Information

Therapeutic Intervention Support - Level of Experience of Presenting Need(s)

Safety Plan in Place?

Yes

Is there a Current Risk Assessment?

Yes

Please upload the current risk assessment

Max. 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 here

Max. file size: 50 MB.

Please upload the SENDATS CAPT-TI Practitioner School Agreement here

Max. file size: 50 MB.

SEND Advisory Support - Pupil Information further details

Has this child recently moved to your setting(Required)

Yes

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)

Training Session/s Request 2

Training Session/s Request 3

SENDATS: Training Request - Details of training session

Date/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

Time available for session/s to be delivered (in hours/mins)(Required)

Time of the day for training to take place(Required)

For example 4PM

Number of participants(Required)

Please enter a number greater than or equal to 1.

SENDATS: Training Request - Details of training session

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 details

SENDATS Home Tuition - Referral details

Reason 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 need

Primary area of need(Required)

Additional area of need

SEND Advisory Support - Pupil further information

What 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

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 levels

Maths(Required)

English - reading(Required)

English - writing(Required)

Current attendance percentage(Required)

SEND Advisory Support - Current attainment levels

If the student is persistently absent please outline what steps have been taken to address this

Has this child had any fixed term exclusions(Required)

Yes

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 details

Please 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 details

Has your school had any other recent training (from SENDATS, in school, other providers)?(Required)

Yes

Please provide a brief summary

SENDATS Home Tuition - Student's current needs

Current Needs(Required)

Please Provide a Summary of the student’s current needs which are impacting on school attendance

SENDATS Home Tuition - Support and provision details

Support 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 details

SENDATS Home Tuition - Services involved details

Services 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 views

SENDATS: Home Tuition - Parental views

Parental views on Referral(Required)

SEND Advisory Support - Student views

SENDATS: Home Tuition - Student views

Student 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

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 request

What 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)

SENDATS: Exceptional Request - Details of request

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 provision

Please 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

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 Referrer

SENDATS Home Tuition - Details of Referrer

SENDATS: Exceptional Request - Details of Referrer

This field is hidden when viewing the form

Details of Referrer

First name(Required)

Last name(Required)

Role(Required)

School / Service(Required)

SEND Advisory Support - Details of Referrer

SENDATS Home Tuition - Details of Referrer

SENDATS: Exceptional Request - Details of Referrer

Phone Number(Required)

Referrer email(Required)

Name of key contact for ongoing liaison with SENDATS Tuition Team (if different)