Primary School SEND Enquiry Form

Pupil Information

Full Name* Date of Birth* Year Group/Class*

Areas of Concern

Please tick all that apply and provide brief detailsCommunication and Interaction (speech and language concerns)Cognition and LearningSocial, Emotional and Mental HealthSensory and/or Physical NeedsMedical

Other (please specify) Additional Information – Please give details of your concerns, your discussions with school staff and actions taken and what you would like the outcome of this enquiry to be.

Parental Information

Name* Contact Number* E-mail Address*

Please note that the school can no longer make referrals to CAMHS linked to concerns of neurodiversity unless there is an accompanying mental illness. In these cases, please seek the support of your GP. Should the school have concerns that your child has a neuro developmental difficulty, the school will provide a letter of support.

Access to an educational psychologist at school is extremely limited, prioritised for children based upon needs. While we understand every child is important, referrals are carefully considered to ensure support is directed where needed most.