Make a referral

Refer a student

Whether you're a parent, school or local authority, we're here to answer your questions and guide you through the next steps.

FOR SCHOOLS & LAS

Refer a pupil or request further information

Schools and local authorities can contact us to discuss potential placements, check availability or request more detail about our provision. We’ll talk through a pupil’s needs, agree expectations and outline the next steps clearly.

NEXT STEPS

Once we receive your message, our team will respond promptly to:

Answer your questions

Discuss the pupil’s needs (if applicable)

Explain how our provision works

Outline the referral or enquiry process

You’ll always know what the next step is and what information we need from you.

Student Details

Student Name

Student Address

Student Postcode

Student Date of Birth

Student School Year

Parental Conacts

First Contact Name

First Contact Phone Number

First Contact Email Address

Second Contact Name

Second Contact Phone Number

Second Contact Email Address

Emergency Conacts

First Contact Name

First Contact Phone Number

First Contact Email Address

Second Contact Name

Second Contact Phone Number

Second Contact Email Address

Have Parents / Guardians been made aware of the referral?

Does the student require one to one support?

Is the student receiving free school meals?

Are you wanting the student to start ASAP?

Suggested days of the week they would like to attend?

Referrer Details

Referrer Name

Referrer Position

Referrer School

Referrer Phone Number

Referrer Email Address

EHCP? (if yes please forward)

Risk Assessment? (if yes please forward)

Invoice Contact

Invoice Contact Name

Invoice Contact Email Address

Daily Attendance

Attendance Contact Name

Attendance Contact Email Address

About the Referral

Reasons for the referral and learning goals

Professionals Involved

(Please add any relevant names)

Social Worker

Healthy Young Minds

Youth Offending Services

Any other relevant professionals (eg doctor)

Important Information

Essential questions, please answer where relevant

Any risk factors?

Any additional support needed?

Any SEND needs?

Any medical conditions or allergies?

Details of any medication

Details of any substance abuse

Details of any concerning behaviour

Any criminal behaviour, current or historical?

What other setting is the student attending?

What curriculum subjects are accessed outside of Chances Mentoring?

What are the last recorded education results / working level

When were these results recorded?

Any other essential information