Get the free Oregon ABCD EIECSE Referral Form

Clacks Education Service District Phone: 503-675-4097 Fax: 503-675-4205 Universal Referral Form for Early Intervention/Early Childhood Special Education (EI/ELSE) Providers* CHILD/PARENT CONTACT INFORMATION

How to fill out oregon abcd eiecse referral

How to fill out Oregon ABCD EIECSE referral:

1. Begin by accessing the official Oregon ABCD EIECSE referral form online. You can find this form on the Oregon State government website or through related healthcare providers.
2. Carefully read the instructions at the beginning of the form. These instructions will provide important information on how to correctly fill out the referral.
3. Fill in your personal information in the designated sections. This may include your name, address, contact details, date of birth, and any other relevant information requested.
4. Provide information about the child who requires the referral. This may include the child's name, date of birth, gender, and any existing medical conditions or special needs.
5. Indicate the reason for the referral. Specify the specific service, treatment, or evaluation that the child needs.
6. If applicable, provide information about the referring physician or healthcare provider. This may include their name, contact information, and any additional details required.
7. Review the completed form for accuracy and completeness. Ensure that all required information has been provided and that there are no errors or omissions.
8. If required, sign and date the form at the designated section. This signature may be provided by the parent or legal guardian of the child.
9. Submit the completed referral form according to the instructions provided. This may involve mailing or delivering the form to the appropriate healthcare provider or organization.
10. Keep a copy of the filled-out referral form for your records.

Who needs Oregon ABCD EIECSE referral?

1. Families with children who require specialized services, treatments, or evaluations in Oregon may need an Oregon ABCD EIECSE referral. This program is designed to provide support and assistance to children with developmental delays, disabilities, or special healthcare needs.
2. Healthcare providers or physicians who identify a child's need for specialized services can also initiate an Oregon ABCD EIECSE referral. They may refer children who require interventions, therapies, or assessments to ensure their overall well-being and development.
3. It is important to consult with healthcare professionals or organizations familiar with the Oregon ABCD EIECSE referral process to determine if a referral is necessary and to understand the eligibility requirements.

For pdfFiller’s FAQs

What is oregon abcd eiecse referral?

Oregon ABCD EIECSE referral is a form used to refer children to the Early Intervention/Early Childhood Special Education program in Oregon.

Who is required to file oregon abcd eiecse referral?

Healthcare providers, educators, and other professionals who suspect a child may have developmental delays or disabilities are required to file Oregon ABCD EIECSE referral.

How to fill out oregon abcd eiecse referral?

Oregon ABCD EIECSE referral can be filled out online or in person by providing information about the child's development, any concerns, and contact information for the family.

What is the purpose of oregon abcd eiecse referral?

The purpose of Oregon ABCD EIECSE referral is to help identify children who may benefit from early intervention services to support their development and learning.

What information must be reported on oregon abcd eiecse referral?

On Oregon ABCD EIECSE referral, information such as the child's demographics, developmental history, concerns, and contact information for the family must be reported.

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