(Illinois ABCD III Project) This form is used by Early Intervention to report back the status of a referral to the referring source and PCP. Part I is used initially to indicate whether early intervention has been able to reach the family and assign a coordinator. Part II is used later to inform the referring source and PCP about early intervention eligibility and services. The state will continue to make changes to this form in an effort to make it more compatible with state EI reporting systems.
https://healthychild.nashp.org/wp-content/uploads/2019/09/NASHP-Logo.png 0 0 admin https://healthychild.nashp.org/wp-content/uploads/2019/09/NASHP-Logo.png admin2016-05-03 06:01:212016-05-03 06:01:21Illinois Early Intervention Fax Back Form