Early Years SEND

Early Years Referral form


The new Early Years Referral form can be downloaded by clicking the button below.  This form should now be used by all practitioners for all referrals, whether for whole setting support or for support for individual children, and replaces all previous forms.   

Please delete all previous forms and use just this one for all your Early Years referrals.  To ensure you always use the latest version we suggest you download a new form from this webpage before making each referral. 

Our new email address should be used for all Referral Forms and as well as all other Early Years enquiries, please email: eyservice@gloucestershire.gov.uk   

Request for Support Form

EY Checklist

The Early Years Service SEND offer


Multi-Agency Planning (MAP) group


Please note: there is now a new process in place for referrals into the Multi-Agency Planning (MAP) group. 

Please contact your Early Years Lead Advisor (EYLA) in the first instance.

Gloucester and Forest:

Bev Green, bev.green@gloucestershire.gov.uk.  Mobile: 07796 183794

Kim Nicholls, kimberley.nicholls@gloucestershire.gov.uk.  Mobile: 07796 610433

Charlotte Smith, charlotte.smith@gloucestershire.gov.uk.  Mobile: 07741 097323

Cheltenham and Tewkesbury:

Ruth Price, ruth.price2@gloucestershire.gov.uk.  Mobile: 07796 610496

Sarah Cousins, sarah.cousins2@gloucestershire.gov.uk.  Mobile: 07769 886126

Stroud and Cotswolds:

Catherine Hardwick, catherine.hardwick@gloucestershire.gov.uk.  Mobile: 07909 937184

Steph Kirby, stephanie.kirby@gloucestershire.gov.uk.  Mobile: 07818 858474

or email: eyservice@gloucestershire.gov.uk

Referrals to MAP group should be made for a child who has:

  • Medical/educational needs requiring additional support with learning/development.
  • Additional needs that have not been met by following the graduated approach as outlined in the SEN Code of Practice/Gloucestershire Guidance Booklet for Professionals working with Children and Young People with SEND.

Referrals can be made to MAP group to apply for inclusion grant funding or other assistance to help support a child and the setting they attend.

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