Inclusion Referral Form

Please see here the revised  SES Referral Form.

The revised form should be used for the following purposes:

· The Specialist Education Services (SES): Cognition and Learning, Specific Learning Difficulties, Communication and Interaction, Speech, Language and Communication, SEMH and Sensory / Physical

· Whole School Inclusion Service

For all of the above four areas, please send your referral form from 1st September 2021 to [email protected]

Please note that for referrals for the SPLSA service, appendix 1 must also be completed.

The Inclusion Referral Form should be used for the following purposes:

. ATS referrals

· IYFAP referrals

· Permanent exclusion

· Alternative Provision / PRU requests

· Requests for placement in Reception / Key Stage 1 specialist units

For the above four areas, please send your referral form from 1st September 2021 to [email protected]

Please note that for referrals for ATS,  the ATS appendix and risk assessment must also be completed.

Please note that for PEXs and IYFAP referrals, a risk assessment must also be completed.

Appendix for ATS

Appendix 1 – Health

Inclusion Referral Form

Inclusion Service – Pupil Risk Assessment