Reception SEND questionnaire 2019

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Please tell us the name of the practioner

First name

Surname

Enter details of the child arriving in reception class where you were not aware of the child’s significant needs

First name

Surname

Date of birth of the child

Names of parent or carer

First name of Parent/Carer 1

Surname of Parent/Carer 1

First name of Parent/Carer 2

Surname of Parent/Carer 2

Address of the family

Address Line 1

Address Line 2

Town/City

Postcode

NHS number, if known

Briefly describe the child’s needs

Social and emotional mental health

Physical needs

Interaction and communication (includes ASD and AHD)

Social care needs

Severe health needs

Other (please specify):

This is required

Do you arrange home visits for new children coming into reception?

Yes

In nursery

What information were you able to gain from the parent about any services involved?

Health Visiting

Family Nurse Partnership

Specialist Children’s Services

SALT

Physiotherapy

Paediatric assessment

Other (please specify):

This is required

Did the parents access Children’s Centre Services?

Yes

Did the parents access childcare or a child minder?

Yes

Is the family a recent arrival to Tower Hamlets (less than a year)?

Yes

If yes, please tell us the date the family arrived to the borough (if known).
MM/YYYY

Did the child have a:

2 year integrated review at a Children’s Centre

2 year integrated review in another location (e.g. GP surgery, Health Centre or at home) with a Health Visitor

Neither of these

Unaware

What information were you able to gain from the parent about whether the child attend a childcare provision?

previous setting information

health information

EHCP

None

If the child attended a childcare provision did they contact you to arrange transition planning?

Yes

Don't know

Did you receive a summary of the child’s learning progress form from the previous setting?

Yes

Would you like a copy of the case study template so that you can record your experiences?

Yes

Please tell us the name of the school

Please tell us the name of the practioner

Enter details of the child arriving in reception class where you were not aware of the child’s significant needs

Date of birth of the child

Names of parent or carer

Address of the family

NHS number, if known

Briefly describe the child’s needs

Do you arrange home visits for new children coming into reception?

What information were you able to gain from the parent about any services involved?

Did the parents access Children’s Centre Services?

Did the parents access childcare or a child minder?

Is the family a recent arrival to Tower Hamlets (less than a year)?

If yes, please tell us the date the family arrived to the borough (if known).
MM/YYYY

Did the child have a:

What information were you able to gain from the parent about whether the child attend a childcare provision?

If the child attended a childcare provision did they contact you to arrange transition planning?

Did you receive a summary of the child’s learning progress form from the previous setting?

Would you like a copy of the case study template so that you can record your experiences?

Any other comments

Page 1

Please tell us the name of the school

Please tell us the name of the practioner

Enter details of the child arriving in reception class where you were not aware of the child’s significant needs

Date of birth of the child

Names of parent or carer

Address of the family

NHS number, if known

Briefly describe the child’s needs

Do you arrange home visits for new children coming into reception?

What information were you able to gain from the parent about any services involved?

Did the parents access Children’s Centre Services?

Did the parents access childcare or a child minder?

Is the family a recent arrival to Tower Hamlets (less than a year)?

If yes, please tell us the date the family arrived to the borough (if known).MM/YYYY

Did the child have a:

What information were you able to gain from the parent about whether the child attend a childcare provision?

If the child attended a childcare provision did they contact you to arrange transition planning?

Did you receive a summary of the child’s learning progress form from the previous setting?

Would you like a copy of the case study template so that you can record your experiences?

Any other comments

If yes, please tell us the date the family arrived to the borough (if known).
MM/YYYY