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Referral Form for a Psychological Assessment 2026

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  1. Click ‘Get Form’ to open the Referral Form for a Psychological Assessment in our editor.
  2. Begin by filling in the child's personal information, including their name, date of birth, and address. Ensure accuracy as this information is crucial for identification.
  3. Complete the section regarding family details, including family size and any preschool attendance. This helps provide context about the child's background.
  4. Address any concerns regarding early development and special talents. Be detailed in your responses to give a comprehensive view of the child’s abilities and challenges.
  5. In the assessment history section, list any previous evaluations by professionals such as psychologists or therapists. Attach relevant reports if available.
  6. For teacher input, ensure that both class teachers and learning support staff complete their sections accurately, detailing academic support received and behavioral observations.
  7. Finally, obtain necessary signatures from parents or guardians on the consent form to authorize the assessment process.

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