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713.970.7005 713.696.2133 713.838.0926 281.644.1846 BACH ECI Bay Area Rehab ECI Project GROW ECI UTMB ECI LAUNCH 979.848.8337 281.838.4480 281.261.2584 281 534-4270 For programs outside Houston Area, call: Dars Inquiry Line: 1.800.628.5115 Child s Name: DOB: ID# Diagnosis (ICD10 code, etc.) Birth Weight: Gestational Age: Y N Y N I have examined this chi.

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