To help ensure a smooth application, please take time to gather relevant information together before starting the application, including potentially storing the required documents on your computer or device. If, for any reason you need to leave the form part way through the session, it may time out and your work might not be saved. To avoid this we would advise setting aside time to fully complete the form.
Before you complete this form, please make sure that you have available all evidence in support of your application.
Instructions
Before you start this referral into the Early Years Inclusion Team, please ensure the criteria below is fulfilled and evident within the information on this form and within the attachments you upload.
If your concern is focused on hearing or vision needs, please do not complete this form until you have telephoned the Bromley Sensory Support Service - 01689 889 850 (Hearing) / 01689 889 856 (Vision) to clarify if it is appropriate to access these services.
Criteria
- The child must be significantly delayed in two or more of the prime areas in the Early Years Foundation Stage (EYFS).
- We require one reviewed cycle of assess, plan, do, review as part of the graduated response approach recorded within your setting SEN Support Plan or record. Unless there are exceptional circumstances which prevent this and that you have discussed first with your Area SENCo.
Uploading supportive documents
To ensure successful submission of referral, please make sure attachments do not exceed the maximum limit of 18MB. Where possible please avoid using individual photographed pages of a document as this will use large amounts of data. If the limit is exceeded the submission will be rejected.
At the end of the submission, you will be emailed a copy and issued with a reference number. If you do not receive this, the submission has been unsuccessful, and you will need to start again.
Consent and General Data Protection Regulations 2018 (GDPR)
It is essential that you ensure the parent/carer is aware of the following GDPR statement.
The information on your child is provided/gathered in accordance with the Data Protection Act 2018 (DPA) and the General Data Protection Regulations 2018 (GDPR).
You may receive services from a number of people. So that we can all work together for your child’s benefit, we may need to share information.
We only ever use or pass on necessary information if and when professionals have a genuine need for it. Law strictly controls the sharing of sensitive personal information. Anyone who receives information from us is also under a legal duty to keep it confidential. All data are stored on a secure database. Relevant information shared will remain confidential through observance of the DPA (2018) and GDPR (2018).
The legal basis for processing your data is set out in Article 6 of the GDPR:
To make the initial referral
(a)Your consent for one or more specific purpose
For necessary information processing and sharing to provide you with services
(c) Compliance with the council’s legal obligations;
(e) Carrying out a task in the public interest or in the exercise of official authority.
Our legal basis is underpinned by Special Educational Needs and Disability Act 2001
This privacy statement should be read in conjunction with the Education Privacy Notice.
Ticking the boxes below confirms your consent to the above statements
SEN Support Plan/Evidence Checklist
Please tick to indicate that your evidence includes ALL of the following information that we require. You must complete all sections in order for us to accept the referral
