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CHILD STUDY COMMITTEE REFERRAL FORM Date Submitted to School Office: The following information will be used to petition a formal request to be placed on the Child Study Team agenda. Before completing
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How to fill out child study committee referral

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How to fill out the child study committee referral:

01
Start by obtaining the referral form from the relevant authority or agency. This may be the school district, a pediatrician, or a social worker.
02
Begin by filling out the general information section. Provide the child's name, date of birth, address, and contact details.
03
Next, fill in the details about the child's current educational setting. Include the name of the school or program, the grade level, and any specific concerns or issues that need to be addressed.
04
Provide information about the child's primary caregiver or legal guardian. Include their name, contact information, and any additional details that may be relevant.
05
Answer the questions regarding the reason for the referral. This may involve identifying any academic, behavioral, or social-emotional challenges that the child is facing.
06
If applicable, provide information about any previous evaluations or interventions that have been conducted for the child. This could include any testing, therapy sessions, or support services received.
07
Finally, review the completed referral form for accuracy and completeness before submitting it to the appropriate committee or agency.

Who needs a child study committee referral?

01
Parents or legal guardians who have concerns about their child's academic, behavioral, or social-emotional development may need a child study committee referral.
02
Teachers or educators who notice challenges or difficulties in a student's learning or behavior may also initiate a child study committee referral.
03
Additionally, healthcare professionals, social workers, or specialists working with children may recommend a child study committee referral if they identify any areas of concern that require further investigation or support.
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A child study committee referral is a process of referring a student who may be in need of additional support or services to a committee for evaluation and intervention.
Teachers, parents, or school administrators may be required to file a child study committee referral if they believe a student may need additional support or services.
To fill out a child study committee referral, detailed information about the student's behavior, academic performance, and any special needs should be provided.
The purpose of a child study committee referral is to identify students who may need extra support or services to succeed academically and emotionally.
Information such as the student's name, grade, academic performance, behavior concerns, and any previous interventions should be reported on a child study committee referral form.
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