Online Referral Form

Fill out our form to refer a student to SENsational Tutors, and receive a list of recommended tutors.

1Referrer Details

Your Name*

Your Email address*

Your Phone number*

What is your relationship with the Child/Young person?*

I am the Child/Young person’s parent, guardian or carer

I work at the Child/Young person’s school or college

I work at the Local Authority

Other

2Funding

Who will be funding the session?

You can make payment privately, through a personal budget or EOTAS package provided through the LA, via direct payments from the LA, or from other sources.

Name, if different from above

Please provide any further relevant details

3Child/Young Person Details

The Child/Young person’s name*

Child/Young person’s Gender*

Male

Female

Other

How old is the young person?*

Does the young person attend school or college?*

Yes, they do attend

No, they do not attend

Please provide details below if they are being homeschooled and when/if they last attended a school or college.

What academic level is the young person working at?*

Please provide approximate level if unknown

Expected level

Above expected level

Below expected level

Unsure, but likely below expected level as the young person has not attended school for 1+ years

How can the tutor help to engage the student, to develop trust and a meaningful relationship?

What are the hobbies and interests of the young person?

4Diagnoses & Needs

What are the diagnoses, or possible diagnoses and needs of the young person?

Learning and Processing

Working Memory & Processing

Executive Functions

Dysgraphia

Executive Functioning Skills/Study Skills

Communication and Sensory

Speech and Language

Sensory and/or Processing Needs

Social Interaction and Friendship Skills

Non-speaking (Non-Verbal)

Emotional and Behavioural

Anxiety

Trauma

SEMH

Behavioural Needs

Other SEND, please detail below

5Support needs & Requirements

What are the young person’s main areas of needs? What subjects or areas of special educational needs do they need support with?

Tick all that apply

Other support needed, please detail below

Is the child currently receiving any other specialist support?

Tick all that apply

Speech and language therapy

Occupational therapy

Medical Support

Other

Has the child received tutoring support in the past?

Tick all that apply

Yes, with a private individual

Yes, with an agency

N/A or unsure

Other

Please provide any further details

6About the sessions

When would you ideally like to start sessions?*

As soon as possible

On a specific date

When funding is approved

Other

Would you prefer online, in person, or either online or in person sessions for the right tutor?*

Online

In person

Either, for the right match

When would you ideally like the sessions?

To help us match your child to the most suitable available tutor/s, please be as flexible as possible. Select all possibilities and all that apply:

Weekends

Sat

Sun

Holidays

Other

Add any further details or information here

How many hours per week?

Hours

Minimum 1.5 hour per session

How many sessions would you like per week?

Note: most tutors will request a minimum of 1.5 hours per session for sessions in person and a full EOTAS package is normally 25 hours per week

7About the Tutor

Ideally, what training, qualifications, skills, experience or other requirements should the specialist SEN teacher have?

Are there any particular tutors that you want to be introduced to?

Please search for a tutor via the platform here.

Yes, I am interested in being introduced to a specific tutor(s)

No, I don’t have any preference. Please contact all tutors on my behalf and send me the profiles of any available tutors.

Do you have a budget in mind?

Note: all specialist SEN tutors set their own rate per hour. This is generally between £90-£120 per hour.

Yes

No, I don’t have any budget

8Health, Safety and Safeguarding

Are there any health and safety concerns or issues at the location where the tutoring will take place?

Yes

Not applicable

Are there any behavioural/communication needs or triggers that the tutor should be aware of?

Yes

Not applicable

Who would you like to nominate as the responsible adult?

This person will also deliver first-aid to the child, if necessary.

Myself

Other

If the sessions are taking place outside the home, e.g. in a library, who should the tutor initially contact in case of emergency?*

You are also nominating this person to deliver first-aid to the child, if necessary.

Not applicable, the sessions will take place in a home environment

Yes, sessions are taking place outside the home

Please provide details of any other areas regarding safety and wellbeing of the tutors or young person that are not covered above

9Total costs and split-payments

All tutors are self employed and therefore set the total payable rate, generally ranging between £90-£120 per hour. Total cost includes our agency fee and in most cases will also include travel expenses, travel time, resources, feedback time, report writing and assessments. You can read our costs page on the website. Please discuss all costs directly with the tutor.

We operate a transparent split payment process. After an initial session, once a month you will receive one invoice from your tutor (70% of total cost) and one invoice from SENsational Tutors (25% plus VAT = 30%)

Thank you, I understand*

10Agreement to share this booking form

Yes, I agree that SENsational Tutors Ltd can share this completed booking form with any tutors that I wish to be introduced to. This includes all contact information and information about the child/young person.*

11Final comments

Any other details or information that will help us with the matching process

How did you hear about us?*

If you found us via an online search platform e.g. Google search, what did you search for?

Relevant downloads

Essential documentation including Policies and Terms and Conditions.

Introductory Pack

130KB

View

Policy Pack

1.44MB

View