Get the free early intervention (ei) referral form - Hawaii State Department ...

Service Coordination Agency Early Intervention Referral Form CHILD AND CAREGIVER INFORMATION Parent/caregiver name & relationship to child: County: Child name: Child date of birth: Parent/caregiver

How to fill out early intervention ei referral

How to fill out early intervention ei referral

1. Start by gathering all necessary information about the child, such as their name, age, date of birth, medical history, and any existing diagnoses or disabilities.
2. Contact the local Early Intervention program or agency in your area to obtain the necessary referral forms. This can typically be done through a phone call or by visiting their website.
3. Fill out the referral forms carefully and accurately, providing as much detail as possible about the child's developmental delays or concerns. It is important to include specific information about the areas in which the child is experiencing difficulties, such as communication, motor skills, or social interactions.
4. Attach any supporting documentation or evaluation reports, such as assessments performed by healthcare professionals or therapists, if available.
5. Submit the completed referral forms and supporting documentation to the Early Intervention program either by mail, email, fax, or in person, according to their specific instructions.
6. Once the referral is received, the Early Intervention program will review the information provided and determine if the child is eligible for services. If eligible, an evaluation will be scheduled to assess the child's developmental needs and determine the appropriate interventions.
7. Attend the evaluation appointment with your child and collaborate with the evaluators to provide additional information or insights about your child's strengths and challenges.
8. Based on the evaluation results, an Individualized Family Service Plan (IFSP) will be developed and implemented, outlining the specific goals, services, and supports that will be provided to address the child's developmental delays.
9. Be an active participant in the Early Intervention program, attending therapy sessions or interventions as scheduled and communicating regularly with the service providers to monitor your child's progress and make any necessary adjustments to the IFSP.
10. Periodically review and update the IFSP as needed, ensuring that the child's developmental goals are still relevant and that the services and supports being provided are effectively addressing their needs.

Who needs early intervention ei referral?

1. Any child between the ages of birth to three years old who is experiencing developmental delays or has a diagnosed disability may need an Early Intervention (EI) referral.
2. Examples of children who may benefit from an EI referral include those who have difficulty with communication skills, motor skills, social interactions, cognitive abilities, or adaptive functioning.
3. Parents or caregivers who have concerns about their child's development, such as delayed milestones, regression in skills, or persistent difficulties in certain areas, should consider seeking an EI referral.
4. Professionals, such as pediatricians, therapists, or educators, who work with young children and notice signs of developmental delays or concerns, may also recommend or initiate an EI referral for the child.
5. It is important to consult with healthcare professionals or EI specialists in your local area to determine if a child needs an EI referral and to obtain appropriate guidance on the referral process.

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What is early intervention ei referral?

Early intervention ei referral is a process where children who may be at risk for developmental delays or disabilities are connected to services and support at an early age to help them reach their full potential.

Who is required to file early intervention ei referral?

Parents, caregivers, healthcare providers, or educators who suspect a child may benefit from early intervention services are required to file an early intervention ei referral.

How to fill out early intervention ei referral?

To fill out an early intervention ei referral, one can contact their state's early intervention program and provide information about the child's development and any concerns about their progress.

What is the purpose of early intervention ei referral?

The purpose of early intervention ei referral is to identify children who may benefit from early support services to address developmental delays or disabilities.

What information must be reported on early intervention ei referral?

Information such as the child's age, developmental concerns, contact information, and any assessments or evaluations should be reported on an early intervention ei referral.