Get Suffolk County Early Intervention Program Session Note Childs Name: Dob: Providers Name: Provider

This guide provides detailed instructions on completing the Suffolk County Early Intervention Program Session Note effectively. Follow the steps to ensure all necessary information is captured accurately for the child's early intervention sessions.

Follow the steps to fill out the session note with ease.

1. Press the ‘Get Form’ button to retrieve the session note and open it for editing.
2. In the ‘Child’s Name’ field, enter the full name of the child receiving services.
3. Next, fill in the ‘DOB’ (date of birth) field with the child’s date of birth in MM/DD/YYYY format.
4. Enter the ‘Provider’s Name’ in the corresponding field alongside the ‘Provider NPI#’ and ‘License #.’ Be sure to input the National Provider Identifier (NPI) and license numbers accurately.
5. Indicate the agency name as ‘Up Wee Grow, Inc.’ and provide the agency’s NPI number. Ensure that the number is correct.
6. Fill in the ‘Auth. Period’ dates: from and to, specifying the authorization period for services, and include the EI Auth # and ICD9 code where applicable.
7. Specify the ‘Authorized Service’ or discipline and the type and location of the service provided.
8. Complete the date and time fields for the session. Clearly state the time span from start to finish and include the relevant CPT Codes.
9. In the ‘IFSP Outcomes Addressed’ section, check off any applicable items and note whether the session was cancelled or if it was a make-up session.
10. Detail the activities and strategies used during the session along with the child’s response to these activities.
11. Indicate the progress made by checking the appropriate box: no progress, limited progress, or progressing.
12. Check any relevant activities involving the parent or caregiver that occurred during the session.
13. Provide suggestions for integrating strategies into the child’s daily routines.
14. Confirm that services were delivered in accordance with the frequency and duration specified in the IFSP.
15. Signatures from the parent/caregiver and provider need to be obtained along with the date and the relationship to the child noted.
16. Finally, save your changes, and download, print or share the completed form as needed.

Complete your Suffolk County Early Intervention Program Session Note online today to ensure effective documentation.