PRE-ENROLMENT INTERVIEW REQUEST FOR INFORMATION

The School Education Act 1999 requires the provision of: ‘details of any condition of the enrollee that may call for special steps to be taken for the benefit or protection of the enrollee or other persons in the school’ (s.16G). To assist the school to respond to individual requirements please detail any special needs your child has in the following areas that affect his/her learning, participation or welfare during school hours or at school-related activities (carnivals, camps, excursions, etc). Non-disclosure of any medical or learning support conditions may affect the status of the enrolment at a later stage.

Pre-Interview Enrolment Form

STUDENT DETAILS

MEDICAL AND HEALTH CONDITIONS

Does your child have any medical or health conditions?

MEDICATIONS

Does your child require medication?

HAS YOUR CHILD RECEIVED ANY OF THE FOLLOWING?

Psychological or psychiatric services
Learning support

DOES YOUR CHILD HAVE ANY NEEDS IN THE FOLLOWING AREAS?

Sensory (e.g. vision/hearing)
Behaviour or safety
Communication (e.g. speech therapy)

ALLERGIES

Does your child have any allergies?

MEDICAL ALERT BRACELET

Does your child wear a Medical Alert Bracelet?

SERVICES FROM EXTERNAL AGENCIES

Does your child receive any services from an external agency which may affect educational arrangements?

SERVICES DURING SCHOOL HOURS

Does your child require any medication or medical/health care services during school hours?

Maximum file size: 2.1MB

PARENT/GUARDIAN ACKNOWLEDGEMENT

I/We acknowledge that I/we have fully disclosed any particular needs (including but not limited to any medical, physical, learning or psychological needs) of our child. Where any disclosed special needs change or where any special needs arise, I/we agree to notify the school immediately. I/We also agree to complete my/our child’s medical form accurately and provide annual updates for the school, including any health matter that arises during the year that may impact on other students or staff, or the ability of the school to care for my/our child.

Please tick box to indicate your consent with these terms and conditions for each applicable Caregiver.
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