Discounted Assessment Booking Form & Deposit – to be made bespoke

The agreed assessment date will be held for 2 weeks; this booking is only confirmed on receipt of this FULLY completed form and deposit payment (£100 plus £5 administrative fee with a further £100 installment to be paid as agreed). If after two weeks this form has not been completed the date will be given to the next person on the waiting list. If you are unable to complete this form and make payment, for whatever reason, please contact Caro on to discuss.

By completing this form, it is understood that as this child/young person’s parent/guardian or as the commissioning adult you have read, understood and agreed to the following terms and conditions about the forthcoming assessment/session.

Please find our GDPR policy on the website.

It is also understood that by completing this form you are giving us permission to contact school/college/workplace for information about the child/young person/adult unless we have discussed otherwise. If you have any queries, please do not hesitate to contact Sonja on or Caro on

Please allow 15-20 minutes to process and complete this form, it must be completed in its entirety, it cannot be saved and returned to.

TERMS AND CONDITIONS

The Process:

1. Either myself, Caro Strover-Green or a CSGA Associate Educational Psychologist or one of our trained Assistant Psychologists will be allocated to the assessment, guided most of all by ‘fit’. An Assistant Psychologist is an honours psychology graduate who we have trained and closely supervise. They are British Psychology Society affiliated with a role that is formally recognised within the profession https://www.bps.org.uk/assistant-psychologist-job-profile. These roles are important as a pre cursor for their doctorate programme. We supervise closely from planning through to the report so effectively you have two psychologists attending to the assessment.
2. The commissioning parent/adult needs to check that the school/college/workplace can provide a quiet working space with a table and chairs for the morning of the assessment on the allocated date. If not, then please get back to us before completing this form, so we can organise another date.
3. Following receipt of this form, the parent/guardian/commissioning adult will then receive a link to a questionnaire, requesting background information on this child/young person/adult and for views on their learning.  This is expected to be completed and returned in good time before the assessment.  This, with other contributions and any professional reports will help plan the assessment as well as contribute to the assessment.
4. Caro Strover-Green, a CSG Associate Psychologist or one of the Assistant Psychologists will then administer an educational psychology assessment with this child/young person/adult to provide an independent evaluation dependent on the concerns, which will include the child/young person/adult’s views about their learning, an evaluation of their strengths and difficulties and recommendations.  The assessment will involve one-to one work and may include an observation in class (if necessary).  The structure, pace and foci of each assessment will vary depending on the needs of the pupil. The assessment will last all morning with breaks as appropriate, and if further assessment has been requested, possibly into the afternoon.
5. Multiple factors contribute to learning and it is important to appreciate context.  To this end, early developmental history, general medical health, hearing, vision, home life, sibling relations, self-esteem, confidence and social and emotional skills, and any significant events will all be considered, and it is important that responses are given to all parts of the questionnaire.
6. In order for the assessment to take place, parental/guardian consent must be provided.  It is up to this consenting parent/guardian/commissioning adult to make any others with parental responsibility aware that the assessment is taking place, so that they may also contribute to the process if they wish. Each person with parental responsibility will have a right to see the report on request.
7. It is best practice to gain school/college/workplace’s views about this child/young person/adult’s progress, attainments, support and well-being.  To this end, agreement to these terms assumes that, unless otherwise discussed, you are giving permission for us to liaise with this child/young person/adult’s school/college/workplace  and request their perspective and further information, e.g. completing a questionnaire, Individualised Learning Plans and reports from other professionals that they might have on file.
8. The parent/guardian/commissioning adult will give the name and contact details of other professionals that have been involved within their information form, and by signing this agreement they give permission that we can contact these professionals if further information is required.
9. Feedback on the assessment is offered in a zoom call following receipt of the report, at a mutually convenient time for us, parent/guardian/commissioning adult, and school/college/workplace, or any other professional who may be involved and where it is relevant that they attend.

The report:

• Details of the assessment will be provided in a written report which is usually sent within 14 days of the assessment.
• The report will include the full detail of the assessment and include the appropriate background context, and recommendations in line with the individual findings of the assessment

The child/young person’s involvement in the assessment:

• It is very important to hear the child/young person’s views about their learning and this is an important part of an assessment.
• Prior to an  assessment, it is often helpful for child/young person to hear about the assessment: what it is for and what it entails. Briefly, the answer to this is: to help ascertain their learning strengths and weaknesses, in order to work out strategies and support that will help them help themself with their ownlearning as well as help teachers adapt their teaching to best support them; or if an adult, to give recommendations to make appropriate accommodation and support within the work place/learning environment.
• The assessment itself involves lots of short and varied activities.
• If this child/young person would like to know more about what an educational psychologist does, they are welcome to refer to the website www.edpsych.co.uk
• If this child/young person is very anxious about the session, please contact Caro and we can arrange a short zoom for introductions and a general chat.

Fees:

• The charge for the different assessment and possible additions are listed below. Please look at the options and put a cross in the box to show what you would like the assessment to cover. It might be that on preparing, we suggest some changes.
• If there are financial difficulties, please contact us to discuss payment options.
• The report is only released on completion of payment.
• Balance payment by internet transfer is preferred, and bank details are given on the invoice.
• The fee covers: the time it takes to request, collect and consider the background information requested via questionnaires sent out to school/college/workplace and parents, and school reports; preparing the assessment, the assessment time, feedback and the report with recommendations.  Informal follow up if appropriate over the subsequent months is also included.
• Additional processing of previous assessment reports to prepare the assessment, such as previous optometrist, speech and language, educational psychology, occupational therapy or private tutor reports, are important to process and will be charged at pro rata basis of an additional £25 per report (dependent on the length of the report) with a charge of £75 for multiple reports.  This will also include any further relevant communication between the professional and us. Please email copies of these reports when you return this form.
• If there is no communication or prior agreement, interest will be applied to the invoice at 2% per month pro rata if the invoice is not paid  within 7 days of the invoice being emailed to the client.
• The fee does not cover international telephone calls or mileage costs/travel time.
• Travel is charged at 45p per mile from and return to Marlborough,
• A one-off service charge of £100.
• If an assessment is cancelled after the preparation has commenced or within 24 hours of the booking date, a cancellation fee may be charged to cover the time spent in preparation, and to cover the loss of revenue if it is not possible to use the cancelled date for other work.

Data processing and storage – in compliance with the General Data Protection Regulation (GDPR) (Regulation (EU) 2016/679

Please read the following information carefully:

• The finalised educational psychology report for assessment and any other information will be stored on Cliniko, for 5 years, which is secure and meets GDPR standards (for the purpose of reference, in the case of a request for future re-assessment, input or on request by parent/guardian for a copy if their copy has been lost).
• During the time of the assessment process, information will also be stored on the working laptops which are all password protected.
• Practitioners are ICO registered.
• Copies of the report are confidential and emailed to the parent/guardian/commissioning adult (and other authorised parents or family) as a pdf document, password protected in line with GDPR, unless otherwise requested by you. School/College will also be copied into the same email, unless specifically requested otherwise.
• Most questionnaires are sent and then stored using Cliniko software which is secure encrypted software.
• You can request that other professionals who are involved with supporting this child/young person/adult can also receive a copy of the report.
• Any hard copies of reports, background information forms, assessment booklets and notes will be destroyed shortly after the assessment.  All necessary information will be recorded in the full report or stored in Cliniko.