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Early Childhood Mental Health Consultation Classroom Referral FormReferral Date: ___ / ___ / ___Please email referral form to MHCintake@eliotchs.org or fax to 8572884612 Child Care Providers Information
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How to fill out early childhood mental health

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Begin by gathering necessary information such as the child's demographic information, family history, and any behavioral concerns.
02
Assess the child's mental health by observing their behavior, emotions, and interactions with others.
03
Use standardized screening tools to further evaluate the child's mental health status.
04
Collaborate with parents or caregivers to gather additional insights and perspectives on the child's mental health.
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Develop a comprehensive treatment plan that addresses the child's specific mental health needs.

Who needs early childhood mental health?

01
Early childhood mental health services are important for children between the ages of 0-5 years old who may be experiencing behavioral, emotional, or social challenges.
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Parents, caregivers, educators, and healthcare providers may also benefit from early childhood mental health support in order to help young children thrive and develop in a healthy manner.
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Early childhood mental health refers to the emotional and social well-being of young children, including their ability to form secure attachments, regulate emotions, and develop social skills.
Providers of early childhood services such as caregivers, educators, and mental health professionals are required to file early childhood mental health documents.
To fill out early childhood mental health forms, providers must document observations, assessments, and interventions related to a child's mental health and well-being.
The purpose of early childhood mental health reporting is to track and support the social and emotional development of young children, identify any potential concerns early, and provide appropriate interventions.
Information reported on early childhood mental health forms may include behavior observations, developmental milestones, social interactions, and any mental health concerns or interventions.
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