Get Justification Document Template 2020-2025

Filling out the Justification Document Template is an essential process for requesting changes in frequency, intensity, or method of services in the NYC Early Intervention Program. This guide will provide clear, step-by-step instructions to ensure that you complete the form accurately and efficiently online.

Follow the steps to complete the Justification Document Template online.

1. Click ‘Get Form’ button to obtain the Justification Document Template and open it in the editor.
2. Fill in the child's Early Intervention (EI) ID number and personal details, including the child's name, date of birth, as well as information about the service provider and supervisor.
3. Complete the authorization information, ensuring all required fields such as IFSP start and end dates, authorized service, and the number of sessions are filled accurately.
4. In the 'Request for Change' section, indicate whether you are requesting termination of service or an increase/change in service frequency, duration, or method.
5. Address the Required Justification Components by numbering your responses according to the order specified. Ensure that each question is thoroughly answered.
6. Detail the child's current function, explaining their level of function, recent developments, and comparisons to their previous status.
7. Outline the services provided to date, including the start date, any prior providers, and an explanation of any service gaps.
8. Describe family involvement in the process, highlighting how caregivers are supported and any observed successes or difficulties.
9. Discuss service plan coordination, detailing communication and collaboration with other team members regarding IFSP outcomes.
10. Clearly state the IFSP outcomes being targeted, short-term objectives, progress made, and any alternative strategies employed.
11. Conclude with details on the recommended changes, new proposed outcomes, and how these changes will impact the child's daily routine.
12. Review all information for completeness and accuracy. Save changes to ensure your responses are captured. Download, print, or share the form as needed.

Complete your Justification Document Template online today to ensure your service needs are addressed promptly.