EmailMe Form - Intervention Request Form

Name of student: *

Year: *

Subject: *

Member of staff referring: *

Request supported by: *

(LiL/HoD)

Outline of concern: *

Interventions already attempted: *

What would you like to be achieved through intervention?: *

Disclaimer:

By sending this request form it does not automatically lead to an additional intervention being triggered.

It is important that the strategic intervention team leadership are aware of all issues and concerns so to develop the most effective 'needs lead' intervention team.

You will be made aware of the outcome of your request in due course.