Starting Reception Sept 2022

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Dear parent,
I am delighted you have chosen St Bernadette Nursery class for your child. In order for us to start planning for your child’s start, it is helpful to know if your child has any needs that they are currently receiving support for, or if you are in the process of requesting support. I would appreciate it if you would complete the information below and submit it by Monday 28th June 2022. If there is anything on the form that you feel you need to discuss before your child starts, please contact me at earlyyears@stbernadetteschool.co.uk and I will arrange a time with you to either phone or meet in person.

I look forward to meeting you at the induction meeting in July.

Miss Simpson (Assistant Head/EYFS phase leader)

Child's Name *

Child's date of birth *

Does your child have any of the following diagnosed special or additional needs? Please tick the correct box or boxes: *

No additional needs

Autism spectrum disorder (already diagnosed or in the process of diagnosis)

ADHD (already diagnosed or in the process of diagnosis)

Speech and language delay (e.g. attending/referred to speech and language therapy, or you have concerns)

Physical needs (diagnosed conditions, e.g hypermobility, or other concerns)

Developmental delay in terms of learning and the standards expected at your child’s age (either diagnosed, e.g. at CDC or 2 year old health check, or noted by an educational professional)

Behaviour that you are concerned about (please specify below)

Other medical needs (please specify below, e.g. hearing, eyesight, allergies)

Has been referred to the Child development centre, no diagnosis as yet

Was your child born with any medical issues that may or may not have had an effect on their development so far?

Previous/current Nursery setting or medical professional has expressed concerns – please indicate below and discuss with your child's new class teacher

Was your child born prematurely, i.e. before their due date? (this information helps us to plan appropriately for their needs)

Other:

Required

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