Neurodevelopmental forms for requesting support (referrals)

The following page provides neurodevelopmental forms that parents and schools may need to access or complete. Including:

• Forms that schools and parents need to fill out to request a Neurodevelopmental school consultation.
• Forms which may be requested for schools/parents to fill out during the diagnostic assessment process (you do not need to complete these forms unless advised by a member of the Neurodevelopmental Service).
• Other forms including ADHD medication review

The Neurodevelopmental Service provides diagnostic assessments for the following conditions:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Autism Spectrum Disorder (ASD)

We are only commissioned to assess young people who are registered under a Surrey GP. 

Requests for support can be made by a school for children that are over 6 years old and up to 17 years and 6 months. For young people older than 17 years and 6 months their GP will need to refer to adult services.

Neurodevelopmental School Consultations

The way to access an assessment with the Neurodevelopmental Service is to make a referral via the consultation route.

Step One:

A member of school staff (e.g. SENCO, class teacher) needs to email ndspoke@sabp.nhs.uk with the below information:

• Young person’s name 
• Young person's date of birth 
• School name
• School email (for a specific member of staff who we can liaise with)
• Parent name & parent email
• Any risk noted to self/others/from others
• The criteria which is met for a consultation. More information on the criteria can be found on our Neurodevelopmental diagnostic pathway page.

Please use the child’s full name and date of birth as the subject line.

Please attach all forms listed in Step Two with this email.

Step Two:

The second step is for school and parents (and the young person where appropriate) to collaboratively complete the following forms. 

• Client Demographic Form - To be completed by parent/guardian
• Assessment of Need Form - To be completed collaboratively by parent/guardian and school SENCO
  • Please read the guide to completing the Assessment of Need Form
• Young person view form (age 12+) - To be completed by the young person, if they are 12 years and over
• Autism Spectrum Quotient (AQ) form (14+) - To be completed by the young person, if they are 14 years and over
• My Safety Plan - To be completed by the young person

*Please note, that emails with missing information, or missing documents, may not be processed and there will be a delay in accessing the service.

Step Three:

Once the Neurodevelopmental Service have processed your email, school staff and parent/guardian will be sent email links (to the email addresses provided) to complete further online screening questionnaires. This includes:

• Conners 4 questionnaire sent to school staff
• Conners 4 questionnaire and Social Communication Questionnaire (SCQ) sent to parent/guardian

Step Four:

Once the paperwork has been completed online and submitted to ndspoke@sabp.nhs.uk, a practitioner will review the forms, and then make contact with the parents/carers and schools to explain the outcome:

• If the evidence clearly suggests the need for further assessment, and support is already in place for the young person both at home and at school, then the young person will be placed on the waiting list without the need for further consultation. A letter will be sent to the parents/carers, school and GP to confirm the outcome and with recommendations to support the young person's needs.
• If needs are complex, different at home and school, or it is clear that there are unmet needs, then the practitioner will contact the school to book in a consultation.

Additional Forms that might be required during the consultation/ diagnostic assessment

During the consultation or assessment process, there may be some additional forms which need to be completed. Please only complete the following forms if you are asked to do this. All forms are in Word document format, just click on the form name below to download a copy.

• PADH form - To be completed by parent/guardian
• School information form - To be completed by the school
• Update to the Assessment Of Needs form - To be completed by parent/guardian
• Parent SNAP form - To be completed by parent/guardian
• School SNAP form - To be completed by the school

Other useful forms to request support

ADHD - Post diagnosis ADHD medication

These forms should only be completed if advised by the Neurodevelopmental team. 
 

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