Get Technical Assistance Request Form 2015 2016 Child ... - Uvm

Filling out the technical assistance request form is an important step in accessing critical support services for your child. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the child information section, provide the child's name, date of birth, home address, and phone number. Ensure all details are accurate to avoid delays.
3. Indicate if your child is Medicaid (Dr. Dinosaur) eligible by selecting 'Yes' or 'No'. This information is crucial for determining eligibility for services.
4. Move to the eligibility section. Confirm that your child meets all the listed criteria by responding 'yes' to each question regarding age, medical needs, and required supports.
5. In the child's schedule section, note the days and hours when the child is available at home, childcare, or other settings. This helps in coordinating services.
6. Complete the team members section by providing the necessary information for all team members involved, including names, emails, and phone numbers.
7. In the current identified needs section, check all boxes that apply to describe the child’s needs. This allows the team to tailor their assistance based on the specific requirements.
8. In the technical assistance needs section, indicate the team's needs by checking all relevant boxes. This helps in identifying the type of support required for the child.
9. For the referral question, state the central question regarding the child to direct the team's focus effectively.
10. Finally, fill in your name and the date the form is completed. Review all entries for accuracy, then save your changes, download the form, print it, or share it as needed.

Complete your technical assistance request form online today to ensure your child receives the necessary support.