Get Soonerstart Referral
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How to fill out the Soonerstart Referral online
Filling out the Soonerstart Referral form is a crucial step in connecting infants and toddlers who may need early intervention services. This guide provides clear, step-by-step instructions to help you navigate the form effectively.
Follow the steps to complete the Soonerstart Referral form accurately.
- Click ‘Get Form’ button to obtain the Soonerstart referral form and open it for editing.
- Begin by providing the Parent/Child Contact Information. Fill in the child's name, parent or guardian's name, date of birth, and age in months. Include contact phone numbers for home and other, followed by the home address and primary language spoken.
- In the Reason(s) for Referral section, check all applicable boxes that describe the child's condition or concerns. Provide additional details as needed, especially under suspected developmental delays or when referring based on screening tools.
- Complete the Referral Source Contact Information by filling out your facility or organization name, date of referral, address, city, state, zip code, phone number, and fax number. Ensure that the name of the health care provider making the referral is also included.
- In the Request for Referral to Sooner Start section, print the name of the parent or guardian granting permission. Sign and date the form to confirm the authorization for sharing pertinent health information.
- Make sure to initial confirming receipt of the Notices of Privacy Practices as required by HIPAA, indicating your understanding of how the protected health information may be used.
- After completing the form, you can save any changes made. Options for sharing include downloading or printing the form to fax it directly to the appropriate regional office.
Complete the Soonerstart Referral form online to ensure timely support for the children in need.
Examples of early intervention services include speech therapy, occupational therapy, physical therapy, and developmental support. These services are tailored to meet each child's unique needs, ensuring comprehensive support. With a Soonerstart Referral, families can connect with qualified professionals who provide these essential services. Ultimately, this leads to better outcomes for children facing developmental challenges.
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