- This form will take approximately 15 minutes to complete.
- Please allow yourself enough time to complete this form in one session as there is not an option to save and come back to it later.
- The questions marked with an asterisk (*) are mandatory and require an answer. You do not have to answer all of the other questions, but it would help us if you do.
- We advise that you review the Education Health and Care guidance document before submitting your request. This document provides helpful information regarding the thresholds for assessment, as well as information about how requests are considered.
- Before you submit a request you should discuss this with your school/college. We will need to seek information from them about how they meet your needs and how they support you as part of our considerations. The consideration of an Education Health and Care Needs Assessment (EHCNA) is best when young people, families and settings work together to consider the suitability of the Assessment.
Your data privacy
This explains why we ask for your data, what we do with it and how long we will keep it. It also explains how you can find out what data we hold about you and how you can ask us to delete it.
Select your title.
It is very important you discuss this request with your school/college before you submit this form. We are required to seek advice from them regarding your needs and support. This process is most effective if the request is made in a joint manner between home and school.
Details of the person helping you with the request
Select their title.
This information will be used to consider the suitability of an Education Health and Care Needs Assessment for you.
In order to do this we may need to share the details in this assessment request form with other organisations or services.
We are obliged to share information if there are any concerns about the safety and/or wellbeing of a child, young person and/or adult and if there are clear reasons for doing so which are in the best interests of a child, young person and/or adult.
Enter any further details to support your request.
Freedom of information
Your details will be used in accordance with the Freedom of Information Act (FOIA) 2000 and the Data Protection Act (DPA) 1998 or other appropriate legislation, and will be stored electronically. If information you have provided is personal, as defined under the DPA, we will only use it for the purpose for which you provided it. We only share your personal data with a third party if we are required to do so by law or if we need to in order to provide the service you have requested.
I am in agreement with the request for an Education, Health & Care Needs Assessment.
I agree to West Sussex County Council seeking any relevant information from other professionals to help them in deciding whether it is necessary to carry out an Education, Health & Care Needs Assessment.
If an Education, Health & Care Needs Assessment is approved I agree to West Sussex County Council seeking further professional advice and/or assessment to help them decide whether it is necessary to issue an Education, Health and Care Plan.
Submitting your form
Click the submit button only once.
Please be patient as it will take a few moments to process your form and redirect you to our confirmation page.