☐ ☐ ☐ ☐ c) Communication: making self Please describe help/equipment needed: understood understanding others ☐ ☐ ☐ ☐ d) Interpersonal Relationships: Please describe help/equipment needed: making and keeping friends behaving in acceptable ways coping with feelings Section 7 Help and supervision – Answer the following if the service user is five years old and over: 1. Unable to 2. 3. Does not 4. Does not do or always Sometimes need help but need help and needs help/ needs help/ uses aids does not use supervision supervision /equipment aids/ equipment ☐ ☐ ☐ ☐ e) Learning: understanding new Please describe help/equipment needed: ideas remembering problem solving decision making paying attention undertaking single or multiple tasks carrying out daily
c) Communication: making self understood understanding others ☐ ☐ ☐ ☐ Please describe help/equipment needed: d) Interpersonal Relationships: making and keeping friends behaving in acceptable ways coping with feelings ☐ ☐ ☐ ☐ Please describe help/equipment needed: Section 7 – Help and supervision Answer the following if the service user is five years old and over: 1. Unable to do or always needs help/ supervision 2. Sometimes needs help/ supervision 3. Does not need help but uses aids /equipment 4. Does not need help and does not use aids/ equipment e) Learning: understanding new ideas remembering problem solving decision making paying attention undertaking single or multiple tasks carrying out daily ☐ ☐ ☐ ☐ Please describe help/equipment needed:
WA-Disability-Professional-Services-school-age-referral-form-2014.docx