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EPS Early Intervention Referral Form CHILD NAME: First ___ Last___ DOB: ___ SEX (M/F):___ RACE:___ ETHNICITY: (Hispanic or NonHispanic):___ U.S. CITIZEN: ___ LANGUAGE (Please mark with X): English:
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How to fill out eps early intervention referral

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How to fill out eps early intervention referral

01
Obtain the EPS Early Intervention Referral form from the appropriate agency or organization.
02
Fill out the referral form completely and accurately with all required information.
03
Provide detailed information about the child's developmental concerns or delays.
04
Include any relevant medical history or diagnoses that may impact the child's development.
05
Submit the completed referral form to the designated contact person or agency for review and follow-up.

Who needs eps early intervention referral?

01
Children who show signs of developmental delays or concerns
02
Parents or guardians who have concerns about their child's development
03
Healthcare providers or educators who suspect a child may benefit from early intervention services
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EPS Early Intervention Referral is a process that allows for the identification and support of infants and toddlers who may be at risk for developmental delays or disabilities, providing them with necessary services.
Professionals who work with young children, such as pediatricians, teachers, and social workers, are typically required to file EPS early intervention referrals if they identify a child who may need additional support.
To fill out an EPS early intervention referral, you need to complete a designated referral form, providing detailed information about the child's strengths, concerns, and any relevant observations or assessments.
The purpose of the EPS early intervention referral is to ensure timely access to evaluation and services for infants and toddlers who may face developmental challenges, promoting their growth and optimal development.
The referral must include the child's relevant personal information, developmental concerns, family background, any assessments conducted, and the reason for the referral to early intervention services.
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