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Referral Date: ENID# Summit Co. Referral to Help Me Grow Child s Last Name: M.I. Birth Date: Ethnicity: ? Hispanic Sex: Male Female ? Non-Hispanic ? Mexican/Mexican American/Chicana RACE(S): ? American
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How to fill out help me grow referral

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Who needs help me grow referral?

01
Parents and caregivers with children aged birth to 3 years old who may have developmental concerns or delays.
02
Early childhood professionals who work with young children and families, such as pediatricians, teachers, child care providers, and social workers.

How to fill out help me grow referral:

01
Begin by visiting the Help Me Grow website or contacting your local Help Me Grow program.
02
Provide basic information about yourself, such as your name and contact information, as well as the child's name and date of birth.
03
Indicate the reason for your referral, whether it is due to concerns about the child's development, behavior, or any other related issues.
04
Include any relevant observations or specific areas where you have noticed the child may be struggling or experiencing delays.
05
If available, provide additional information such as medical history, assessments, or observations from other professionals who have worked with the child.
06
Lastly, submit the referral form or follow the instructions provided by your local Help Me Grow program.
Remember, seeking a Help Me Grow referral is not limited to parents and caregivers. Early childhood professionals who work closely with young children and families may also utilize this referral system to ensure that children receive the necessary support and resources they need to thrive.

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Help me grow referral is a program designed to identify and support children with developmental delays or disabilities.
Healthcare providers, educators, and family members are required to file help me grow referral.
Help me grow referral can be filled out by providing information about the child's developmental milestones and concerns.
The purpose of help me grow referral is to ensure early intervention services are provided to children who may need additional support.
Information such as the child's age, developmental concerns, and contact information for the family must be reported on help me grow referral.
The deadline to file help me grow referral in 2023 is typically within a specific timeframe after the concerns are identified.
The penalty for the late filing of help me grow referral may result in delays in receiving necessary support services for the child.
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