This form contains 30 fields organized into 10 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Actions/Strategies Implemented to Date
Refer to Compass for current plans in place	Checkbox	Check this box when the student’s existing documented plans are stored in Compass and you are referring the reviewer to those current plans rather than listing strategies on this form.
Actions/Strategies Implemented to Date	Text	Describe the specific actions, documented plans and evidence‑based strategies already used with the student to address the concerns (for example whole‑class or small‑group interventions, social & emotional programs, escalation profiles, functional behaviour assessments), including dates, duration and brief outcomes where relevant.
Case Manager Sign-off
Case Manager Name	Text	Enter the full name of the case manager responsible for this referral. Max length: 31 characters
Case Manager Signature	Text	Enter the name or electronic signature of the case manager who is signing this form. Max length: 24 characters
Case Manager Sign-off Date — Day	Checkbox	Tick this box to indicate/record the day component of the Case Manager's signature date after signing the form.
Case Manager Sign-off Date — Month	Checkbox	Tick this box to indicate/record the month component of the Case Manager's signature date after signing the form.
Case Manager Sign-off Date	Date	Enter the date when the case manager signed this section. Max length: 5 characters
Parent/Carer Discussion Confirmation
Parent/Carer discussion — Yes	Checkbox	Check this box when school concerns have been discussed with the parent(s)/carer(s) and they have agreed to the Request for Assistance.
Reason if parents/carers not consulted or did not agree	Text	Enter the reason why parents/carers were not consulted or why they did not agree to the Request for Assistance (briefly explain circumstances or barriers). Fill only if 'Parent/Carer discussion — Yes' is 'No'. Max length: 72 characters Depends on: Parent/Carer discussion — Yes
Reason for Referral Details
Reason for Referral (Details)	Text	Describe the observable behaviours and concerns and explain how they affect the student’s learning, including relevant evidence such as frequency data, triggers/consequences, academic or NAPLAN results, diagnostic test results, and any observational data.
Response to Intervention Details
Response to Intervention Details	Text	Describe what interventions have been tried and specify what the student has and has not responded to, attaching relevant data and reviewed support plans (e.g., frequency data, progress notes, consequences, assessment results).
School Psychologist - Date Request Received
Date request received	Date	Enter the date the School Psychologist received the request. Max length: 5 characters
Date request received - Month	Checkbox	Check this box after entering or confirming the month (MM) portion of the 'Date request received' field.
Date request received - Day	Checkbox	Check this box after entering or confirming the day (DD) portion of the 'Date request received' field.
School Psychologist - Date Returned to School
Date Returned to School - Day (first digit)	Checkbox	Check this box to record the first digit of the day (the tens place) for the 'Date returned to school' field. Fill only if 'RfA Not accepted' is 'Yes'. Depends on: RfA Not accepted
Date Returned to School - Day (second digit)	Checkbox	Check this box to record the second digit of the day (the ones place) for the 'Date returned to school' field. Fill only if 'RfA Not accepted' is 'Yes'. Depends on: RfA Not accepted
Date Returned to School	Date	Enter the date on which the School Psychologist returned the RfA decision to the school. Fill only if 'RfA Not accepted' is 'Yes'. Max length: 5 characters Depends on: RfA Not accepted
School Psychologist - RfA Decision
RfA Accepted	Checkbox	Check this box when the School Psychologist has accepted the Request for Assistance (RfA) for this student.
RfA Not accepted	Checkbox	Check this box when the School Psychologist has not accepted the Request for Assistance and will provide a written explanation to the school.
School Psychologist Details
School Psychologist Name	Text	Enter the full name of the school psychologist who completed the request form. Max length: 34 characters
School Psychologist Signature	Text	Provide the school psychologist's signature (typed name or scanned signature) to confirm they have completed the form. Max length: 34 characters
Student Details
Student Name	Text	Enter the student's full name as recorded in school records (given name and surname). Max length: 54 characters
Date of Birth — Day	Checkbox	Check this box to indicate or enter the day (DD) portion of the student's Date of Birth.
Date of Birth — Month	Checkbox	Check this box to indicate or enter the month (MM) portion of the student's Date of Birth.
Date of Birth	Date	Enter the student's date of birth. Max length: 6 characters
Year Level	Text	Enter the student's current year level or grade (for example: Year 3, 7, 11). Max length: 9 characters
Referred By	Text	Enter the name and role of the person making the referral (for example: class teacher, deputy principal, parent). Max length: 33 characters
Date of Request — Day	Checkbox	Check this box to indicate or enter the day (DD) portion of the Date of Request.
Date of Request — Month	Checkbox	Check this box to indicate or enter the month (MM) portion of the Date of Request.
Date of Request	Date	Enter the date the request for assistance was submitted. Max length: 6 characters

School Psychology Request for Assistance 2026 Instructions