Forms to download and complete
Different forms need to be completed depending on the age of the child requiring assessment.
Please ensure the referrer or keyworker has known the child/young person for at least 3 months prior to referral, otherwise the referral may not be accepted. Working with the child/young person for a minimum of three months will ensure you are able to provide sufficient information for the referral.
Under fives
- Single Point of Access referral form - this form also has links to the questionnaires below, which also need to be completed.
- Parent/carer questionnaire
- Teacher questionnaire - nursery/primary school questionnaire - if in a nursery or school setting.
Primary aged children
- Single Point of Access referral form - this form also has links to the questionnaires below, which also need to be completed.
- Parent/carer questionnaire
- Teacher questionnaire - nursery/primary school questionnaire - if in a nursery or school setting
- Vanderbilt questionnaire - parents
- Vanderbilt questionnaire - teacher
Secondary aged children
- Single Point of Access referral form - this form also has links to the questionnaires below, which also need to be completed.
- Parent/carer questionnaire
- Teacher questionnaire - secondary school
- Vanderbilt questionnaire - parents
- Vanderbilt questionnaire - teacher
Returning the completed forms
The completed forms to be sent to:
Email: dhcft.SPOA@nhs.net
If you need to discuss a new or existing referral, the SPOA Administrator can be contacted on 0300 7900 264.