Briefly explain the impact on the child/young person of caring for someone else in the family home; Child/Young Child/Young Child/Young Child/Young Child/Young Person 1 Person 2 Person 3 Person 4 Person 5 Yes Yes Yes Yes Yes l. Does the child/young person have a disability or an No No No No No additional need? know Know know Don’t Know Don’t Know Don’t Don’t Don’t Briefly explain the impact on the child/young person of having a disability or additional need: m. Does the child/young SEN support SEN support SEN support SEN support SEN support person have a Special Educational Need? If so, what Higher needs Higher needs Higher needs Higher needs Higher needs level of support do they Funded (what Funded (what Funded (what Funded (what Funded (what receive? (please tick relevant type) type) type) type) type) Statement or Statement or Statement or Statement or Statement or box) EHC Plan EHC Plan EHC Plan EHC Plan EHC Plan Education, Health and Care (EHC) Plan
Briefly explain the impact on the child/young person of caring for someone else in the family home; Child/Young Person 1 Child/Young Person 2 Child/Young Person 3 Child/Young Person 4 Child/Young Person 5 l. Does the child/young person have a disability or an additional need? Yes Yes Yes Yes Yes No No No No No Don’t Know Don’t Know Don’t know Don’t Know Don’t know Briefly explain the impact on the child/young person of having a disability or additional need: m. Does the child/young person have a Special Educational Need? If so, what level of support do they receive? (please tick relevant box) Education, Health and Care (EHC) Plan SEN support SEN support SEN support SEN support SEN support Higher needs Funded (what type) Higher needs Funded (what type) Higher needs Funded (what type) Higher needs Funded (what type) Higher needs Funded (what type) Statement or EHC Plan Statement or EHC Plan Statement or EHC Plan Statement or EHC Plan Statement or EHC Plan
Additional-Children-and-Young-People-form-section-4-V2.docx