Referral and Care Coordination

Developmental screening, referral for further evaluation, and ongoing interventions and services require coordination among primary care providers, specialists, early care and education providers, early intervention and special education programs, and families to ensure children and families receive appropriate services and do not fall through the cracks. Referral and care coordination require appropriate tools, such as referral forms, feedback mechanisms, and methods of communication among the providers and agencies serving children and families. Many states have developed tools and models for coordinating care, and others will continue to develop care coordination and integration systems using federal resources like the Integrated Care for Kids (InCK) Model (additional NASHP resources on integrated care for children are found here). On this page, you can find examples of referral forms that are compliant with federal health (HIPAA) and education (FERPA) privacy and confidentiality requirements; feedback forms to inform primary care providers of the results of evaluations; and referral guidelines. The below map shows states that have standardized referral forms.

States with Standardized Referral Forms

Referral Map


Has standardized referral form (33)

No known form (18)

* Note: Washington, DC is not pictured on the map, but is included in the counts above. It has an education provider referral form to Part C Early Intervention; English and Spanish versions available. English Form. Spanish Form. Found on this page.

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