Get the free Early Intervention Services / Referrals and Intake Form

Thank you for your interest in the ESL Certification! Please fill out this form to apply. If you have any issues at all with the form, email region×DCI.org. After you email the form, you\'ll receive

How to fill out early intervention services referrals

How to fill out early intervention services referrals

1. Contact your child's pediatrician or pediatric specialist to discuss your concerns and request an evaluation for early intervention services.
2. Obtain a referral form from your child's healthcare provider.
3. Fill out the referral form with accurate and detailed information about your child's developmental delays or disabilities.
4. Attach any relevant documents or medical reports that support your concerns.
5. Submit the completed referral form and documents to the appropriate early intervention services provider in your area.
6. Follow up with the provider to confirm receipt of the referral and to schedule an evaluation appointment for your child.
7. Attend the evaluation appointment and provide any additional information or documentation as requested.
8. Receive the evaluation results and collaborate with the early intervention team to develop an Individualized Family Service Plan (IFSP) for your child's intervention services.
9. Begin receiving early intervention services for your child as outlined in the IFSP.
10. Maintain regular communication with the early intervention team, attend scheduled meetings, and actively participate in your child's intervention progress and planning.

Who needs early intervention services referrals?

1. Children who may benefit from early intervention services referrals include:
2. - Infants and toddlers (birth to 3 years old) who show developmental delays or disabilities in areas such as speech and language, motor skills, cognitive skills, social-emotional development, or adaptive functioning.
3. - Children who have been diagnosed with a medical condition or disorder that may affect their development, such as Down syndrome, autism spectrum disorder, cerebral palsy, or hearing/vision impairments.
4. - Children who have experienced significant trauma or have a history of abuse/neglect, which may impact their overall development.
5. - Children from low-income families or those with limited access to resources and support services.

For pdfFiller’s FAQs

How can I manage my early intervention services referrals directly from Gmail?

You may use pdfFiller's Gmail add-on to change, fill out, and eSign your early intervention services referrals as well as other documents directly in your inbox by using the pdfFiller add-on for Gmail. pdfFiller for Gmail may be found on the Google Workspace Marketplace. Use the time you would have spent dealing with your papers and eSignatures for more vital tasks instead.

How can I send early intervention services referrals to be eSigned by others?

When you're ready to share your early intervention services referrals, you can swiftly email it to others and receive the eSigned document back. You may send your PDF through email, fax, text message, or USPS mail, or you can notarize it online. All of this may be done without ever leaving your account.

How do I complete early intervention services referrals online?

pdfFiller has made it easy to fill out and sign early intervention services referrals. You can use the solution to change and move PDF content, add fields that can be filled in, and sign the document electronically. Start a free trial of pdfFiller, the best tool for editing and filling in documents.

What is early intervention services referrals?

Early intervention services referrals are the process of referring children under the age of three who show signs of developmental delays or disabilities to appropriate services to support their growth and development.

Who is required to file early intervention services referrals?

Healthcare providers, caregivers, and educators are required to file early intervention services referrals for children who may benefit from early intervention services.

How to fill out early intervention services referrals?

Early intervention services referrals can be filled out by providing information about the child's developmental concerns, medical history, and contact information of the referring party.

What is the purpose of early intervention services referrals?

The purpose of early intervention services referrals is to ensure that children with developmental delays or disabilities receive timely and appropriate services to support their development.

What information must be reported on early intervention services referrals?

Information such as the child's name, age, developmental concerns, medical history, and contact information of the referring party must be reported on early intervention services referrals.