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Early Intervention and Early Childhood Special Education referral information and forms


Assistive technology referral resources
  • Assistive technology referral form

Augmentative communication referral resources             
      
  • Augmentative communication referral form
  • Augmentative communication process flowchart
  • Augmentative communication equipment loan agreement: English and Spanish

Health, hearing and vision screening resources

  • Health screening questionnaire: English and Spanish
  • ​Hearing evaluation request
    • Form 30a (Coordinator must complete this form)​
      • IMPORTANT NOTE Regarding Form 30a:
        Clicking the link does not open the form. After you click the link you must download the form to see it.           
  • Hearing screening checklist: English and Spanish
  • Vision screening checklist: English and Spanish
  • Hearing test record form

Mental health assessment referral resources

  • Mental health assessment referral form (Sample Form)
  • Mental health focus
  • Which agency to refer to

Program review resources

  • Program review action planning form
  • Program review request form
  • Program review request guidelines​​
  • Program review request process

​Accessibility
Locations and Service Area

Nondiscrimination Policy

Public Complaint Policy
Report a Safety Concern

Staff Directory

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