Surrey Family Service Supporting Children Team – Request for support from the SEND Team or Early Education and Childcare Team Please complete this form with as much information as possible. Section A should be completed for all requests. Section B should be completed if requesting support for an individual child. Section A: Details of person requesting support Name Role Agency/organisation name, address and Ofsted URN E-mail Telephone address number Date form completed Please complete the below questions (with as much information as possible): What is working well? (What have you already? What have you put in place? If requesting support for a specific child then focus on what works well for the child) What are you worried about? (a child’s sleeping, eating, physical development, communication and language, EAL, emotional development or behaviour, SEND, aspects of the EYFS including practice, policies or procedures, high number of vulnerable groups in current cohort - see cohort information below, high levels of EAL,) What do you want to happen? (what support would you like. Following an Ofsted outcome, practice, the learning environment, staffing, safeguarding/child protection concern or support with SEND processes) Cohort information number of children who are: – looked Under Child in Need In receipt of Free Early (Fostered) Education for two year olds (FEET) On a Child With a Special In receipt of Early Years Protection Plan Educational Need or Pupil Premium (EYPP) Disability Under Early In receipt of In receipt of deprivation Help Disability Access funding Fund (DAF) In receipt of 30 hours Funded Early Education For individual child referrals: Section B: Child’s Forename
Surrey Family Service – Supporting Children Team Request for support from the SEND Team or Early Education and Childcare Team Please complete this form with as much information as possible. Section A should be completed for all requests. Section B should be completed if requesting support for an individual child. Section A: Details of person requesting support Name Role Agency/organisation name, address and Ofsted URN E-mail address Telephone number Date form completed Please complete the below questions (with as much information as possible): What is working well? (What have you already? What have you put in place? If requesting support for a specific child then focus on what works well for the child) What are you worried about? (a child’s sleeping, eating, physical development, communication and language, EAL, emotional development or behaviour, SEND, aspects of the EYFS including practice, policies or procedures, high number of vulnerable groups in current cohort - see cohort information below, high levels of EAL,) What do you want to happen? (what support would you like. Following an Ofsted outcome, practice, the learning environment, staffing, safeguarding/child protection concern or support with SEND processes) Cohort information – number of children who are: looked (Fostered) Under Child in Need In receipt of Free Early Education for two year olds (FEET) On a Child Protection Plan With a Special Educational Need or Disability In receipt of Early Years Pupil Premium (EYPP) Under Early Help In receipt of Disability Access Fund (DAF) In receipt of deprivation funding In receipt of 30 hours Funded Early Education For individual child referrals: Section B: Child’s Forename
request_for_support_v5.docx