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WHO CAN MAKE A REFERRAL

Who can make a referral?

 What information is needed?
  • Parents
  • Developmental disabilities programs
  • Outpatient clinics
  • Well-baby clinics
  • Prenatal/postnatal facilities
  • Public health facilities
  • Hospital follow-up clinics
  • Child day care centers
  • Medicaid programs
  • Physicians
  • Home child day care programs
  • Hospitals
  • Pediatricians' offices
  • Head Start programs
  • Social service agencies
  • Community health services
  • Local educational agencies
  • Other health providers
  • Child's name
  • Sex
  • Ethnic origin
  • Birth date
  • Social Security number
  • Parent name
  • Language spoken by the family
  • Developmental concerns
  • The name of the child's primary care physician
  • Whether the family has agreed to the referral