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Get the free Preschool Initial Referral Intake Form

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This form is intended for the initial intake of referrals for preschool-aged children, collecting detailed information on their personal history, presenting concerns, past diagnoses, family background,
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How to fill out preschool initial referral intake

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How to fill out preschool initial referral intake

01
Gather all necessary personal information including child's name, age, date of birth, and contact information.
02
Complete the parent's or guardian's details, including names, addresses, and phone numbers.
03
Provide information about the child's developmental history, including any concerns or delays observed.
04
Detail any previous evaluations or services the child has received.
05
Include any specific educational or behavioral concerns that prompted the referral.
06
Attach any relevant documentation, such as medical records or previous assessments.
07
Sign and date the referral form to certify that the information provided is accurate.

Who needs preschool initial referral intake?

01
Children who are experiencing developmental delays or learning difficulties.
02
Parents or guardians seeking early intervention services for their preschool-aged children.
03
Educators or professionals who have identified specific concerns about a child's development.
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Preschool initial referral intake is the process through which concerns regarding a child's development are formally documented and assessed to determine whether they are eligible for early intervention services.
Individuals such as parents, guardians, teachers, or healthcare providers who have concerns about a child's development are typically required to file a preschool initial referral intake.
To fill out a preschool initial referral intake, one must provide information about the child's developmental concerns, personal information about the child and family, and any relevant medical or educational history in the designated referral forms.
The purpose of preschool initial referral intake is to identify children who may need early intervention services and to initiate an evaluation to determine their eligibility for appropriate support.
Information that must be reported on preschool initial referral intake includes the child's name, date of birth, contact information, detailed descriptions of developmental concerns, and any previous evaluations or interventions.
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