Get Roanoke County Autism Team Intake Form Name: Date: School:

Completing the Roanoke County Autism Team Intake Form can be a straightforward process when you follow the right steps. This guide will assist you in filling out the form accurately and efficiently to ensure your request is properly communicated.

Follow the steps to successfully complete the intake form.

1. Click the ‘Get Form’ button to access the intake form and open it in your preferred online document editor.
2. Begin by filling in your name in the designated field, ensuring that it is accurate for identification purposes.
3. Next, enter the current date in the section labeled 'Date'. This helps in tracking when the form was submitted.
4. Indicate the school relevant to the request by specifying the school name in the appropriate space.
5. Select the type of service you are requesting by marking the appropriate box for either an in-service for school staff, an IEP team, a consult by the Autism Specialist, or a consult by the Autism Team.
6. If you chose to request an in-service, provide details about your topic of interest in the space provided to help outline the focus of your request.
7. If you are requesting a consult for a student, start filling out the required details such as the student's name and grade.
8. Describe the reasons for the consult by outlining the specific target areas where assistance is needed.
9. List any IEP goals that the student is not currently meeting and explain the reasons behind this to provide context.
10. Specify the primary form of communication utilized by the student, which can help tailor strategies for engagement.
11. Detail the sensory strategies that are being implemented with the student to address their needs.
12. Provide information on the current visual strategies used with the student as this may be relevant for support.
13. Describe what motivates the student and how you incorporate these motivators into their learning.
14. List any concerning behaviors exhibited by the student that require attention and might need further recommendations.
15. Finally, outline your top three concerns about the student, providing space for explanations to guide follow-up recommendations.
16. Once you have completed the form, save the changes, and download or print it if needed. Finally, submit the form to Beth Harman, RCPS Autism Specialist at Central Office, or email it to the provided email address.

Complete your intake form online today for a streamlined process towards receiving the support you need.