Alternative Provision Form
Weekly Attendance and Engagement Record
Review of Service Provided for Week Commencing:
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Day
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Month
Year
Date
Child/Young Person's name:
*
First Name
Last Name
HST professionals working with the child/young person:
*
Please list the full names of the tutors working with the student.
Overview of attendance for this week's sessions:
*
Rows
Overview of hours (enter a number in each box)
Any additional information?
Number of hours scheduled
Number of hours attended
Number of hours cancelled
- By parent/carer/young person
- By Home-School Tutoring
Engagement and behaviour - please use the following scale to provide an overview of the child/young person's engagement and behaviour during sessions:
1 = Dysregulated behaviour or demonstrating behaviours of concern | 2 = Struggling to engage | 3 = Engaged and settled for most of the sessions | 4 = Fully engaged throughout
Rows
Score
This week:
Last week:
Overall since commencement of service:
Details of progress towards specified outcomes:
*
Positive comments for the named child/young person:
*
Challenges:
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Safeguarding:
*
Please use this box to detail any Safeguarding concerns and actions taken to address these concerns
Date report completed:
*
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Day
-
Month
Year
Date
Report completed by:
*
First Name
Last Name
Signature:
*
Submit
Should be Empty: