Requesting a Statutory Education, Health and Care Assessment
for your child
Information for parents/carers
Please note that this form is only for Islington residents. If your child attends an Islington school but lives
outside Islington, please contact the SEN service in your home borough.
Most children will have their needs met from the services that are normally available locally. You can
find details of these services through Islington’s ‘Local Offer’ : www.islington.gov.uk/localoffer.
A statutory Education, Health and Care assessment is something that will only be considered if,
despite access to all of the available local services and supports, your child is not making the
progress that they may be capable of. This will apply to a very small number of children.
It is usually a school or early years setting that asks for a statutory Education, Health and Care
assessment. Very occasionally, parents decide to request this assessment themselves. This is
usually when a child is not attending school or early years setting, or if the school or setting does not
agree that such an assessment is needed.
Where we receive a request, the first decision (whether to carry out an assessment) will be taken
within 4 weeks. All of the information we are given with a request is looked at carefully by a multiagency group of senior officers from education, health and care. The main things they will be looking
for is have all the services that are available to all children been made available to your child in the
proper way, and if so, what impact they have made.
If you do decide to make a request yourself, please use the form below. You may want to ask an
independent parent support worker from Centre404 (a local voluntary organisation who offer a
Parent Carer Support Service) to help you fill it in. They can be contacted on 020 3316 1930. It will
helpful if you can provide as much of this information as possible so that a proper decision about
your request can be reached.
When you have completed this form please return it, together with any relevant reports to:
Islington Special Educational Needs Section
222 Upper Street
London N1 1XR
Email: sen@islington.gov.uk
Tel: 020 7527 5518/4860
When we receive your request, we will contact your child’s school or early years setting, Health and
Social Care to find out if they have any information that we need to know. A SEN Keyworker will also
make contact with you.
Please note that by signing this form on page 5, you are giving your consent for us to obtain and
share information about your child with relevant professionals so that we can make a proper decision
about your request. .
1
Statutory Education Health and Care assessment request
form for parents/carers
1. Your child
First Name:
Surname
Male/Female:
Date of Birth:
Ethnicity:
First Language:
Address:
School (or Early Years Setting):
Year Group:
Have you discussed this request for a assessment with your
child’s school or early years setting?
Yes / No
2. Your details
Title:
First Name:
Surname:
Relationship to Child:
Address (if different from your child):
Email:
Tel No:
3. Details of anyone else who has parental responsibility for the child
Title:
First Name:
Surname:
Relationship to Child:
Address (if different from your child):
Email:
Tel No:
2
My child’s needs
(Why are you asking for a statutory Education, Health and Care assessment? What are you worried about?)
3
Please attach the following information:
Information
Please tick if
you have
included this:
A. Most recent report from an Educational Psychologist
employed or commissioned by the Local Authority
B. Completed CAF (Early Help) assessment
C. Any other specialists advice (e.g. Occupational Therapy,
Physiotherapy, Speech and Language Therapy Services,
CAMHS, Paediatrician, Children’s Social Care) that is relevant
to the child’s learning and development:
Please list reports you are including:
D. Detail of the education providers current arrangements for
supporting your child
E. Copy of your child’s current and most recent individual plan
(e.g. Individual Education Plan, Pupil Passport, SEN Support
Plan) which should include:
 Evidence of baseline assessment from which progress can be
measured
 Records of regular reviews and their outcomes
 Details of your involvement (e.g. home school agreements,
reviews)
 Strategies used
 Additional resources made available to enable your child to
achieve targets
[If the individual plan / provision map does not include all of the
elements above, you may provide separate documentation]
F. Details of your child’s attendance at school / early years
setting for the last three terms
G. Your child’s views, if not already recorded on any of the above
H. Please list all people whose advice should be included as part
of an Education Health and Care assessment, if we agree to
carry one out
I.
A copy of your child’s most recent End of year Report (if this is
not already included with any of the above)
4
For LA
use only:
Received
by LA
Is there anything else you want to tell us that isn’t covered above?
Request for Statutory Education, Health and Care Assessment
I confirm that I am requesting a statutory Education, Health and Care assessment of my child’s
needs. I understand that the Local Authority must seek advice from an Educational Psychologist,
Social Care, Health and other professionals supporting my child’s learning and development and I
give my consent for relevant information to be shared.
Name
Signature
Date
Please return this form, together with any reports from people involved in working with your
child, including the most recent report from their school or early years setting, to:
Islington Special Educational Needs Section
222 Upper Street
London N1 1XR
Email: sen@islington.gov.uk
Tel: 020 7527 5518/4860
5