Name: Role: Contact Number: Email: Date: Please note: This is a confidential document and subject to all the provisions of the DET Privacy Policy Primary- and Sub-presenting Issues Primary Sub Presenting Issue Presenting Issue Attendance Chronic illness Death of significant person/pet Disengagement Developmental delay Has been suspended/expelled Disadvantage Out of home care Family concerns/parenting School Refusal Family conflict/violence Truancy / chronic absenteeism Homelessness Behaviour Aggression/anger [fights with Illness or disability others, swears] Issues related to gender Cries a lot Issues related to sexuality Fights with others, swears Obsessive/compulsive behaviours Hyperactivity /impulsivity Parent separation or divorce Inappropriate social behaviour Parenting strategies Inattention Peer relationships Noncompliance Protective concerns Peer connectedness Sadness Violence Self-esteem Communication Articulation (Production of speech Social skills or Speech sounds) Withdrawal Expressive language (Spoken Difficulty staying on task Curriculum / language) Learning Does not complete classwork / Feeding/swallowing homework Pragmatic language Giftedness Receptive language Hand Writing (Understanding spoken language Learning difficulties e.g. instructions) Literacy Social language skills Numeracy Stuttering Oral language skills Voice Planning and organising Social / Adjustment or transition Short-term memory Emotional Anger; Frustration Well Below expected level of bullied achievement Bullying others Medical, Health, Alcohol or other drug concerns Complaint investigation e.g. from Physical Chronic illness Region
Name: Role: Contact Number: Email: Date: Please note: This is a confidential document and subject to all the provisions of the DET Privacy Policy Primary- and Sub-presenting Issues Primary Presenting Issue Sub Presenting Issue Attendance Chronic illness Disengagement Has been suspended/expelled Out of home care School Refusal Truancy / chronic absenteeism Behaviour Aggression/anger [fights with others, swears] Cries a lot Fights with others, swears Hyperactivity /impulsivity Inappropriate social behaviour Inattention Noncompliance Peer connectedness Violence Communication or Speech Articulation (Production of speech sounds) Expressive language (Spoken language) Feeding/swallowing Pragmatic language Receptive language (Understanding spoken language e.g. instructions) Social language skills Stuttering Voice Social / Emotional Adjustment or transition Anger; Frustration bullied Bullying others Complaint investigation e.g. from Region Death of significant person/pet Developmental delay Disadvantage Family concerns/parenting Family conflict/violence Homelessness Illness or disability Issues related to gender Issues related to sexuality Obsessive/compulsive behaviours Parent separation or divorce Parenting strategies Peer relationships Protective concerns Sadness Self-esteem Social skills Withdrawal Curriculum / Learning Difficulty staying on task Does not complete classwork / homework Giftedness Hand Writing Learning difficulties Literacy Numeracy Oral language skills Planning and organising Short-term memory Well Below expected level of achievement Medical, Health, Physical Alcohol or other drug concerns Chronic illness
SSSstudentinformationform.docx