Referral Resources
This referral letter/parent summary report template is downloadable (in Word) so you can customize it — adding child information and parent contacts, your letterhead, etc. There is also space for parents to sign if willing to give consent for information sharing across services. Please share a completed copy with parents.
Referral Letter Template for the following screeners: PEDS-R®, PEDS:DM®, M-CHAT-R
The PEDS:DM®-Assessment Level Report Template is available as a Word document for download and customization for recording results.
PEDS:DM®-Assessment Level Report Template
Early Childhood Technical Assistance Center (ECTA) houses links to IDEA Part C (birth to 3 years) and Part B (3+ years) services State-by-State, and county-by-county.
Because intake in IDEA programs may be slow, if children are < 6 years and low-income, it is also wise to suggest referrals to local Early Head Start and Head Start programs. These services can obtain help from IDEA (e.g., speech-language pathology, physical and occupational therapy).
For after school/tutoring programs, check with the child’s school of zone, visit the websites of the Boys and Girls Club and the YWCA. Learn about local Early Head Start and Head Start programs.
Find mental health services.
For help locating parent training programs see Parents As Teachers and the YWCA.
Locate quality preschool and day care programs.
The Administration for Children & Families can help you find social services for help with domestic violence, child abuse and neglect, adoption, state, and local services, etc.
