Information

  • Year

  • Personnel

  • Assessment completed

  • Students name & EBS Number or D.O.B.

  • EBS number

  • Banding

  • Previous school

  • LA: (if not Lancashire)

Course/Funding information

Course/Funding Information

  • Course Name

  • School Code

  • Start Date

  • End Date

  • Funding Choice:

  • Aspirations

  • Outcomes (what does the student want to do after this course e.g. Apprenticeship, employment, University?)

Support Requirements

Support Requirements

  • Support Requirements

  • If other please state which:

  • BKSB Maths Initial Assessment Result

  • Diagnostic Result

  • BKSB English Initial Assessment Result

  • Diagnostic Result

Evidence of support requirements (copy held)

  • Form 8

  • Free writing

  • Medical Evidence

  • 139a/EHC Plan

  • SEN

  • All About Me

  • DSA Assessment

  • Needs Assessment

  • Fit to study letter

  • Care Plan/Risk Assessment

  • Ed Psychologist Report

  • CAF/TAF

  • Other

  • If other please state which:

Support History

History of Support

  • In Class Support (which lessons? Shared Support?)

  • EAA

  • If modified paper please give more details: (Font size, colour, paper size etc)

  • Normal way of working

  • Specialist Equipment/Assistive Technology

History of Need

  • What was the aim of support?

  • What worked well/what might have helped you that you didn't have?

  • CAF/TAF

Medical Needs

  • Medical Condition/Allergy/Dietary Information

  • Medication (where is it taken? How is stored?)

  • Do you require personal care?

  • Support from External Agencies (Name and contact details) (Social worker Name, Tel, YPS Advisor)

  • Summary of previous support

Review the following

  • Attendance Issue

  • Reference Check

  • Looked After Child

  • Excluded/Suspended

Pre-enrolment actions required

  • Further information

  • BKSB Assessments

  • Familiarisation Visit

  • Taster in school area(s)

  • New student festival

  • Enrolment Support

  • Personal Care/Payments/Carer Liaison

  • Meeting with PTL/HoS

  • Reason

  • Other

  • Please state:

Tutor Adjustments

Accessing information

  • Difficulties

  • Strategies

  • Other: (please specify)

  • Overlay colour:

  • Colour of pen on whiteboard:

Producing information

  • Difficulties

  • Strategies

  • Other: (please specify)

Working memory / concentration

  • Difficulties

  • Strategies

  • Other: (please specify)

Communication/Social interaction

  • Difficulties

  • Strategies

  • Other: (please specify)

Sensory

  • Difficulties

  • Strategies

  • Other: (please specify)

Support Recommendations/Appointments

Support Recommendations

  • LSA Observations

  • CSW Observations

  • CSW out of class

  • Diagnostic Assessment for HE

  • Counselling

  • Inclusion Contract

  • Learning Mentor

  • Independence Coach

  • EAA

  • EAA - Medical

  • Assistive Technology Assessment - ICT

  • Overlay Assessment

  • Materials Adaption

  • Tutor Adjustments

  • Risk Assessment

  • PEEP

  • Evacuation Chair Training

  • Safe Haven Training

  • Medical alert to school

  • ELM Support

  • Meeting and Taking to class

  • Accompanying to and from transport

  • Travel Training (Taxi)

  • Independent Travel Training

  • Vulnerable Learner

  • Refer to safeguarding officer

  • Achievement Tutor

  • SEN Coding

Declaration

  • The SEN / Learning Support Team wishes to share/release information on a 'needs to know' basis so that we can provide the most appropriate support for you

Disclosure/Enrolment Statement

  • Support required

  • Primary Needs

  • Other (e.g. Reason behind support / declined support)

  • Has the learning difficulty/disability been diagnosed?

  • I agree to this information being shared within college and with relevant outside bodies<br>(e.g. Work placements, exam boards etc)

  • I understand that I may lose my allocated support sessions if I do not attend support sessions regularly and notify the SEN/ Learning Support Team of any absence

  • All requests for SEN / Learning Support will be considered on an individual basis by the SEN / Learning Support Team. Applications for support cannot be processed until all relevant evidence is received.

  • Student signature:

  • Student photo

  • Staff signature:

Admin use

  • Person to cost for:

  • Time taken

  • Date

  • Person to cost for:

  • Time taken

  • Date

  • Person to cost for:

  • Time taken

  • Date

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