Request an EHC - Young person

Use this form to request an Education, Health and Care Needs Assessment if you are a young person aged 16 or over.

  • 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 EHC 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 EHC Assessment is best when young people, families and settings work together to consider the suitability of the Assessment.

Your details

Enter your first name.
Enter your last name.
Enter any middle names separated by commas.
Enter your address name or number. This could your flat, house or building name or number.
Enter the first line of your address. This could be your street name.
Enter the second line of your address if you need to. This could be your village name.
Enter the town or city of your postal address.
Enter your postcode, with or without spaces.
Enter an email address where we can write to you.
Enter a daytime phone number that we can ring you on. This can be a mobile or land line number.
Enter another phone number we can reach you on. This can be a mobile or land line number.
Enter your date of birth using numbers following the format dd/mm/yyyy, for example 01/12/2000.
Select your gender.


Enter your ethnicity.
Enter your first language.
Enter the name of your school/college.

Assessment details

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.

Select 'Yes' if you have discussed this request with your school/college.


Select 'Yes' if someone is helping you with this request?


Further information

This information will be used to consider the suitability of an EHC 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.
Attach any supporting document to support your request
Select 'Yes' if you want to upload another file or photo.

Select 'Yes' if you want to upload another file or photo.

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.

Declaration

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.

Enter your full name to confirm you agree to the above statements, Freedom of information and data protection information.

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.

 

Share this

Do you have any feedback about this page?

Help us improve this website

Let us know how we're doing. We're constantly trying to improve this website. Your feedback is very important to us. You can simply add a star rating to indicate how useful you found this page. If you have more specific feedback use the form below.

Rate this page:
Clear star rating
  • West Sussex County Council will only use this email address to respond to any issues raised.