National Helpline

closed until 8th January 2018

Call us:

0300 302 3731

or

0208 538 3731

Walk in SEN advice centres

Click here for details and locations.


Staff

CASE NOTE INPUT FORM

Volunteer Name:  

Following:
If Other    

Select Advice Centre:
If Other please specify

Date and time:

Child's Surname and Given Name:

Child's Date of Birth:

Special Needs:

Autism          Asperger's Syndrome
Dyslexia        ADHD
Epilepsy        Physical Disability
Dyspraxia      Cerebral Palsy
Down's Syndrome Other
If Other please specify

Diagnosed? Yes No

Current Support: SEN Support
Statement
EHCP
Other
If Other please specify

Main Issue:

SEN Support
Refusal to Assess
Refusal to Issue Statement/EHCP
Dispute content of Statement/EHCP
Exclusion
Transport
Annual transport review
Failure to deliver content of Statement/EHCP
Transition
Other

If Other please specify

Local Authority:

If Other    

Current School Name:

School Type:

Independent Mainstream School
Independent Special School
Maintained Mainstream School
Maintained Special School
Maintained Unit
Academy
Free School
Other
If Other    

 

Call Details:

Action Taken:

Next Step:

Advice Centre
SOS!SEN Website
Workshop
One to One Session
Caller/Customer further action
No action
If Caller/Customer action    

 

Note: Under the terms of the Data protection Act your details will be kept on file at SOS!SEN and will be available within SOS!SEN. It will not be given to any other person without your express permission.

 

Do Not Agree
Agree

Caller's Name:

Select Relationship:
If Other please specify

Contact Tel No:

Contact email:

Entitled to Legal Aid? Yes No Do not know

Join our mailing list? Yes No

Select How did you hear about us?:
If Other please specify