WebStandardized Illinois Early Intervention Referral Form Please complete Sections 1 through 6 of this form to refer a child to Early Intervention (EI) for eligibility determination. Section 1. Child Contact Information Child Name: If the child is known by another name enter it here: Date of Birth: Child Age: Gender: Male Female Race: Address:

Early Intervention for Infants and Toddlers - Virginia Department of

WebOnce the insurance has responded to the provider with an acceptable EOB, the claim and insurance EOB should be submitted within timely filing to the EI-CBO. To verify if a 45 … Webon early intervention (EI) outcomes. Talk with your EI team about strategies and activities that may be especially useful for your family as you work on your EI outcomes. As you talk, you can brainstorm how everyday activities can become opportunities to practice new skills. For example, consider the fun warm . weather pastime of blowing bubbles. how to stay organised for school

Early Intervention - Child and Family Connections of Central Illinois

WebEarly Intervention Services include: Audiology; Assistive Technology; Developmental Therapy; Developmental Therapy-Hearing DTH; Developmental Therapy-Vision … WebAmong the sixteen services offered through Early Intervention are speech, physical, occupational and developmental therapy. Our CFC service coordinators assist families with children from birth to age three with obtaining evaluations and assessments, determining eligibility and arranging for Early Intervention services with therapists. WebSection 5. Early Intervention CFC Office Referral Location Using the attached list of CFC Offices, insert the CFC number where the child is being referred: CFC #: _____ Section 6. Authorization to Release Information 1. Referral to Early Intervention. The purpose of this disclosure is to refer _____ (print how to stay organized as a nurse