Section 1: Instructions
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.
This form must be completed with reference to the guidance and criteria for requests for education, health and care needs assessments.
If an Education Health and Care Needs Assessment (EHCNA) is initiated this form will constitute all or part of the educational advice and will be shared with other agencies as appropriate. It is the educational setting's responsibility to obtain permission from relevant professionals when including additional evidence.
Please don't upload large scanned in documents or images (such as pupil's work or views) to this request as it will cause issues with submitting the form. Please only attach one or two examples.
