Dear Parent(s) /Carer (s)

By completing and returning this form, it is understood that as a parent(s)/carer(s) you have read and understood the following terms and conditions. A copy of my GDPR privacy policy can be found under policy.

Please allow 10-15 minutes to complete this form. All four pages should be completed before submitting the form. You will need a direct contact email for the school SENDCo/Head of Learning.

The assessment process:

• That Emily Vincent will undertake an educational psychology assessment with your child with the aim of providing an independent evaluation of your child’s strengths, difficulties and recommended strategies. Assessments will include one-to-one work with your child and may include an observation in class (if required) and discussion with school staff. The structure, pace and manner of each assessment varies depending on the needs of the child.
• Factors that impact on your child’s education will be considered and commented on if deemed to be relevant, including early development, medical issues, home life, social & emotional skills and behavioural observations.
• In order for me to undertake the assessment, parental consent must be provided by one parent. Please ensure that other individuals with parental responsibility are made aware that the assessment is taking place, so that they may contribute to the process if they wish to do so. In addition, the completed report should be shared with them.
• That Emily Vincent will contact your child’s school (unless specifically requested not to in the space provided) and request that the relevant staff/teacher completes a School Information Form as shown on my website. This will ask teachers’ views of the child’s current situation, educational attainments and details of what support has been provided to date etc.
• A feedback meeting on the day of assessment will be offered, or telephone feedback, to discuss the outcome of the assessment.

The report:

• Details of the assessment will be provided in a written report, which is usually sent at least 15 working days after the assessment day. At busy times this may be longer; it is not always possible to complete reports before this time frame, especially when assessments take place close to school holidays.
• Please be aware I work the equivalent of four days a week and do not work weekends or during state school holidays.
• I would encourage you to take notes during the feedback session if you need to know strategies/details before that time frame.
• Please allow 15 working days before following up on the progress of your child's report and before booking any follow up meetings/appointments.

Fees:

• The standard charge for a cognitive assessment is £625. The report will not be released until payment has been received.
• The balance is due before or on the day of assessment. Payment details will be provided in the confirmation email sent to you on receipt of this form or when contact is first made.
• The fee covers: the time it takes to consider the background information; prepare the assessment; assess the child; provide feedback and write a report including a summary of the findings and recommendations.
• The fee does not cover international telephone calls or mileage costs/travel time.
• If additional assessments are required, further fees of £90 per hour may be charged.
• If an assessment is cancelled after the preparation has commenced/the child does not attend their appointment without notice, a cancellation fee may be charged to cover the time spent in preparation and loss of revenue if it is not possible to use the date for other work.

Data processing and storage – in compliance with the General Data Protection Regulation (GDPR) (Regulation (EU) 2016/679):

Please read the following information carefully and refer to my GDPR policy for further details, which is found on my website:

• Electronic copies of reports, information and relevant emails will be kept securely on my computer and in a GDPR compliant ‘cloud’ for six years, after which time the file will be deleted.
• If you are commissioning (ie paying for) the assessment, copies of the report are confidential and emailed to you only (and any other parent with legal responsibility if requested). If you wish for the report to be shared with other professionals, you will need to forward this yourself.
• If the school has commissioned the assessment, a copy will also be sent to the school, using encryption.
• It is the responsibility of those commissioning the report to keep the report safe once received.
• In order to adhere to the GDPR, reports are emailed to you with encryption/use of Egress; the report will only be sent in PDF and encrypted.
• Background forms, any hard copies of reports and assessment booklets will be shredded every term, after the assessment.   

Parental Information and booking form

Please complete the following information and return it as soon as possible. The form must be received to secure the appointment; dates cannot be held for more than 10 days. A confirmation email outlining all assessment details will be sent as soon as your form is received.

It is important that the information you provide is as detailed as possible (especially any previous assessments and developmental history) as it will help inform my assessment and the conclusions made. Information will also inform my written report.

Please provide as much information as you can about your child’s developmental history and ongoing skills.

Immediate family members, including any step siblings/half siblings:

Please give name, relationship to child and age of any siblings. Please also indicate if the family member lives at home with the child.

Please attach:-

• Copies of any reports from other professionals (hard copies to be sent please if there are more than two reports)
• Copies of Individual Education Plans/My Plans if appropriate

If you would like to send anything please send to: