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Community paediatric referral form: school aged children over 5

All sections should be completed with as much detail as possible
Referrals accepted only from education settings or healthcare professionals. Please be aware that if supporting evidence is not included, the referral will be returned.

If you do not have the relevant information, please discuss with the Setting SENDCO and parent/carer(s).

This form will only be accepted if completed electronically and emailed to

Please note that referrals acceptance must be met:

  • Children must be under a GP within the Buckinghamshire CCG boundaries
  • Under the age of 19 years, except:
  • Children who have recently moved into Buckinghamshire County/or Country
  • Attending a special school
  • Due to the potential need for Occupational Therapy of Speech and Language support we can only accept referrals for children who are registered with a Buckinghamshire GP

Please note: The referral form will download to your computer as a Word doc when you click on the ‘download document’ button.

Supporting documentation:

To ensure the referral can be processed please include the following document with your referral:  School report for referrals to Community Paediatrics