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P.O. Box 53060, RPO South St. Vital Winnipeg, MB R2N 3×2 Phone: 2044150784 Fax: 2042314442 EARLY INTERVENTION PROGRAM REFERRAL FORM 1. CLIENT DETAILS Client name: DOB: Home Address: POSTAL CODE:

How to fill out early intervention program

How to fill out early intervention program:

1. Understand the purpose: Familiarize yourself with the goals and objectives of the early intervention program. Learn about the specific services provided, eligibility criteria, and the overall process.
2. Gather necessary documents: Collect all required documents such as medical records, assessment reports, and any other paperwork requested by the program. Ensure that you have all the relevant information readily available.
3. Schedule an evaluation: Contact the early intervention program office to schedule an evaluation for the individual who requires the services. This evaluation will help determine their eligibility and identify their specific needs.
4. Attend the evaluation: Make sure to attend the scheduled evaluation appointment. Answer any questions asked by the evaluators honestly and provide all necessary information about the individual's development, medical history, and any concerns you may have.
5. Collaborate with the evaluation team: Work with the professionals conducting the evaluation, such as psychologists, speech therapists, or behavioral specialists. Provide them with any additional information they may need to make an accurate assessment.
6. Review the Individualized Family Service Plan (IFSP): Once the evaluation is complete and the individual is deemed eligible, the early intervention program team will create an IFSP. Carefully review and understand the plan, including the goals, objectives, and the services to be provided.
7. Communicate preferences and concerns: Share any preferences or concerns you have regarding the services or goals outlined in the IFSP. It is important to actively participate in the development of the plan to ensure it meets the individual's specific needs.
8. Implement the recommended interventions: Collaborate with the early intervention program team to implement the recommended interventions and strategies outlined in the IFSP. Follow through with any recommended therapies, activities, or strategies at home or in other settings as agreed upon.
9. Participate in progress reviews: Regularly attend progress review meetings with the early intervention program team. Provide feedback on the individual's progress and discuss any needed adjustments to the plan.
10. Advocate for the individual's needs: Be an advocate for the individual's needs throughout the program. Communicate any concerns, request additional support if necessary, and ensure that the program is making a positive impact on the individual's development.

Who needs early intervention program?

1. Infants and toddlers with developmental delays: Early intervention programs are designed to support children who show developmental delays in areas such as communication, social skills, physical abilities, or cognitive functions.
2. Children at risk of developmental delays: Individuals who have a high probability of experiencing developmental delays due to factors such as prematurity, low birth weight, genetic disorders, or environmental factors may also benefit from early intervention programs.
3. Families of children with disabilities: Early intervention programs not only provide services directly to the child but also offer support and resources to the families involved. Thus, families with children who have disabilities can also benefit from early intervention programs.

For pdfFiller’s FAQs

What is early intervention program?

Early intervention program is a systematic program that provides services to infants and toddlers with developmental delays or disabilities.

Who is required to file early intervention program?

Early intervention programs are typically filed by healthcare professionals or educators who work with infants and toddlers.

How to fill out early intervention program?

To fill out an early intervention program, the provider will need to gather information on the child's developmental progress and any interventions or services that have been provided.

What is the purpose of early intervention program?

The purpose of early intervention programs is to help infants and toddlers reach their full potential by providing timely and appropriate services.

What information must be reported on early intervention program?

Information reported on early intervention programs typically includes the child's name, age, developmental needs, goals, and progress.

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