Requesting an EHC needs assessment: An overview
Date completed:
UPN:
Forename:
Surname:
Home address:
Gender:
Ethnicity:
Male 
Date of Birth:
Is the child in care/
looked after?
Other 
Year Group:
Yes

No

Don’t know

Form
completed
by:
Name of school or
setting:
Type of request:
Female 
Parents/carers 
School/setting 
Other: 
Other professionals
already involved
(names when
known and role)
If this is a school request, please complete items 1-8 below and the checklist. Otherwise move
straight to the checklist.
1.Summary of the
reason for the
request:
2.Parents/carers
are aware of the
Yes 
No 
request:
3.Parents views
4. What parents
hope to get from
the assessment?
5. Child/young
person’s view?
6. What is
important to them?
7. What is working
well?
8. What is not
working?
Any other
information
Please add name to the footer so each page can be linked to the child/young person.
First name Surname (DoB)
Page 1 of 3
Criteria checklist for requesting an EHC needs
assessment
Please read the full guidance document www.essexlocaloffer.org.uk/node/2330 before completing
this checklist. Please number all supporting documents you are sending and then indicate where
the evidence for each of the criteria can be found. Based on the definitions within the guidance please
answer the following questions. Please note numbers in these categories will be relatively low.
1. Do you consider that there is a compelling reason to assess?
2. Do you consider the child/young person to have severe and life-long needs
which require an EHCP to provide additional resources to support the
child/young person’s education?
a) Evidence of the child or young person’s
Page numbers where
academic attainment (or developmental
evidence can be found
milestones in younger children) and rate of
progress
The child or young person’s academic attainment
in all areas of learning.
Yes/No
Yes/No
Crosscheck for
use by SAS
The child or young person’s attainment in
assessments and tests compared to the majority of
children that age.
Evidence of the rate and style of the child or young
person’s progress.
Teachers’ own recorded assessments of a child or
young person’s classroom work.
(b) Information about the nature, extent and
Section (b) to be completed only when applicable
context of the child or young person’s SEN and
disabilities
Information about the nature of the child’s/young
person’s SEND.
Information about impact that the SEND is having
on their learning and development.
Evidence of the child or young person’s
performance in different environments.
Information about:
 numbers on roll;
 class or group size;
 staff to pupil ratios in the group or class
(including teachers and learning support
assistants or other support staff);
 other children with SEN or disabilities.
(c) Evidence of action already taken by the
early years setting, school or post-16
institution to meet the child or young person’s
SEN
Evidence of person-centred planning and
coproduction: All planning, decision making and
support should follow from the experiences,
opinions, aspirations, goals and hopes of the child,
young person and the family. This may include use
of planning tools such as a One Page Profile.
Evidence of assess, plan, do and review. For
example, One Planning, Early Support or TAC.
First name Surname (DoB)
Page 2 of 3
Evidence of a focus on outcomes particularly those
important for and important to the child or young
person and the family.
(c) continued
Information about the use of evidence-based
interventions and how their effectiveness has been
monitored and evaluated over time. The use of
the Provision Guidance Toolkit should be
evidenced here.
Evidence of any changes in strategies and
programmes as a result of that monitoring.
(d) Evidence that where progress has been
made, it has only been as the result of much
additional intervention and support at a
sustained level over and above that which is
usually provided
Evidence of how the delegated funding available to
the school or college has been utilised
appropriately and how it has been evaluated.
How services available through the Local Offer
have been accessed and how the impact of these
has been evaluated.
Evidence that the school/college has provided
targeted intervention addressing the child/young
person’s individual needs. Is there evidence of
individual or small group support?
Evidence of active monitoring information
adjustments to the child/young person’s
programmes in the event of limited progress being
made.
Evidence of advice or support from external
services.
Evidence that the child /young person has had
access to Quality First teaching.
Evidence that the school or college have focused
on meeting the agreed outcomes for the child
/young person.
(e) Evidence of the child or young person’s
physical, emotional and social development
and health needs, drawing on relevant
evidence from clinicians and other health
professionals and what has been done to meet
these by other agencies
Evidence of the child /young person’s health,
including their medical history where relevant.
Health Care Plans (where appropriate).
Page numbers where
evidence can be found
Crosscheck for
use by SAS
Section (e) only to be completed when applicable
Evidence of significant social, emotional or
behavioural difficulties, as indicated by clear
recorded examples.
Evidence from assessments or interventions by
health or social services.
Evidence that the setting has had regard to the
DfE guidance on managing the child’s or young
person’s mental health and behaviour difficulties.
First name Surname (DoB)
Page 3 of 3