Contact Educational Psychologist in Hampshire

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Initial Enquiry Form

Once I have your details, I’ll be in contact with you to discuss further.

Your Name*

Your Role (Parent / Carer / School / Other Professional or Organisation)*

Email*

Telephone Number*

Child / Young Person’s First Name (if applicable)

Child / Young Person’s Age: (if applicable)

School and year group/ Organisation Name (if applicable)

Brief reason for enquiry (main concerns or support being sought)*

What are you hoping this enquiry will lead to? (e.g. consultation, training, assessment, supervision, advice)*

Are there other external professionals currently involved or from whom you are seeking advice?*

Is this enquiry related to an EHCP, appeal or tribunal? *

Yes

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Data Protection & Privacy (UK GDPR)
The information you provide will be used solely to respond to your enquiry and to consider whether my services are appropriate. Your data will be stored securely and processed in accordance with UK GDPR and the Data Protection Act 2018. Information will not be shared with third parties without your consent unless legally required. Further details are available in the Privacy Policy.
*

I consent to my information being processed for the purpose of this enquiry.

Safeguarding Notice

I work in accordance with the HCPC Standards of Conduct, Performance and Ethics and the British Psychological Society (BPS) Code of Ethics and Conduct. If information shared indicates that a child or young person may be at risk of harm, I have a professional duty to share relevant information with appropriate safeguarding agencies, in line with statutory guidance.

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Initial Enquiry Form

Safeguarding Notice

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Chartered Educational Psychologist based in Romsey, Hampshire

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