PARENTAL CONSENT TO SHARE INFORMATION AND SEEK ADVICE FROM OTHER PROFESSIONALS (to be completed by person with parental responsibility) Name of child / young D.O.B.: person: I agree with the decision to request an EHC Needs Assessment and understand that this will involve sharing of information about my child with professionals who will support the Local Authority in deciding whether or not to proceed with an EHC Needs Assessment. I agree that the Local Authority may proceed with an EHC Needs Assessment if this is deemed appropriate. I agree that the Local Authority may share information about my child with relevant professionals who have had involvement with my child in the past or who may be asked for advice as part of an EHC Needs Assessment, these may include: Current/Potential Future Educational Setting(s) Community Paediatrician or GP Pupil Referral Unit Speech and Language Therapist Educational Psychologist Occupational Therapist Specialist Teachers Physiotherapist Early Years/Portage Team Adult/Child and Adolescent Mental Health Services Social Care NHS (medical) Consultants Youth Offending Team Any Local Authority or NHS Service involved Date: Signature: Print Name: Relationship to child
PARENTAL CONSENT TO SHARE INFORMATION AND SEEK ADVICE FROM OTHER PROFESSIONALS (to be completed by person with parental responsibility) Name of child / young person: D.O.B.: I agree with the decision to request an EHC Needs Assessment and understand that this will involve sharing of information about my child with professionals who will support the Local Authority in deciding whether or not to proceed with an EHC Needs Assessment. I agree that the Local Authority may proceed with an EHC Needs Assessment if this is deemed appropriate. I agree that the Local Authority may share information about my child with relevant professionals who have had involvement with my child in the past or who may be asked for advice as part of an EHC Needs Assessment, these may include: Current/Potential Future Educational Setting(s) Pupil Referral Unit Educational Psychologist Specialist Teachers Early Years/Portage Team Social Care Youth Offending Team Community Paediatrician or GP Speech and Language Therapist Occupational Therapist Physiotherapist Adult/Child and Adolescent Mental Health Services NHS (medical) Consultants Any Local Authority or NHS Service involved Signature: Date: Print Name: Relationship to child
parental_consent_to_share_information_and_seek_advice_from_other_professionals.docx