Supporting special educational needs and disabilities (SEND) - templates, referral forms and reports

These templates show the type of information that is required detailing what professionals know about a child/young person. The advice provided should be used by the setting when requesting an Education, Health and Care Plan (EHC) assessment, and/or reviewing an existing EHC plan. Settings submitting a request for Top Up funding should complete the new Educational Advice template.

Referral forms

Early years 

• Request for Early Years Support - EY1 form (word version) (DOC, 48.0kb)
• Request for Early Years Support - EY1 form (PDF version) (PDF, 236.7kb)
• Early Years Request for an Education Health and Care Assessment (word version) (DOC, 44.4kb)
• Early Years request for an Education, Health and Care assessment (PDF version) (PDF, 200.8kb)

Request for assessment

• Request for Enhanced Mainstream Provision (word version) (DOC, 36.5kb)
• Request for Enhanced Mainstream Provision (PDF version) (PDF, 191.8kb)

Referrals to services

• Portage Referral Form (word version) (DOC, 64.4kb)
• Portage Referral Form (PDF version) (PDF, 154.9kb)
• SEND and Inclusion Request for Involvement Form (word version) (DOC, 34.7kb)
• SEND and Inclusion Request for Involvement Form (PDF version) (PDF, 226.0kb)

Speech and language referral forms are available on North Tees and Hartlepool NHS Foundation Trust's Speech and language therapy for children page.

The Child and Adolescent Mental Health Service (CAMHS) across County Durham and Darlington has a single point of access for referrals and self-referrals to CAMHS services. To contact the team email tewv.camhscountydurhamdarlington@nhs.net or call 0300 123 9296.

Visit the County Durham and Darlington NHS Foundation Trust website for details about referring to Children's Occupational Therapy.

* Please note that parents/carers must sign the request, and consent to share the forms. Head Teachers must counter-sign the request form if the child/young person is referred by their setting.