• Early Intervention Initial Intake Form

    • I have been informed of my right to view my child’s log notes
    • I have been informed of the confidentiality regulations and understand how my child’s records will be stored and transported.
    • I filled out the allergies form and discussed an emergency plan with my therapist(s).
    • I have discussed the IFSP with the team and understand I may change it at any time upon my request.
    • I have filled out the appropriate consent forms necessary with regards to evaluation, release of medical information, and transfer of records. 
    • I have been informed of the child illness/make-up session policy and procedure.
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