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Test - childrens community learning disability nursing team-behaviour support referral form

Behaviour support referral (THIS IS COPY PASTED - NEEDS CHECKING)

Referral Information

  • For full details of eligibility and criteria to access this service see (DO WE HAVE THIS?)
  • The child must be registered with a GP surgery within the Suffolk boundaries (Waveney is excluded as it is served by Norfolk Suffolk Foundation Trust).
  • If the child is under 5 years old please refer to universal services for support, such as health visitor or children's centre staff.
  • Please ensure that a level one behaviour offer, such as a parenting support course has been completed by the parents or carers before making this referral.
  • Please note referrals highlighting behaviour concerns in the school setting only will not be accepted.
  • Education professionals cannot make a referral to this service, only referral from health and social care professionals will be accepted.
  • If there are numerous areas of need please ask the parent to state their priority need, and detail this in the referral.
  • Please encourage parents and carers to visit our webpage for behaviour support resources.

Please have the following information ready

  • Child's information including date of birth and address.
  • Name of the GP surgery the child is registered with.
  • Parent or carers information including full contact details.
  • Family's spoken language and if they require a translator.
  • Details of the child's disability and any supporting information, such as medical letters or EHCP (Education Health Care Plan) in electronic documents (there is an option to upload any supporting documents in the form).
  • All professionals must gain consent from the parent or carer to make a referral to this service.