30.F08 Sample Form Letter Text (pdf)

This text may be individualized for each child and family and is optional.

Dear (parent/guardian):

(Child's name) was recently referred to Child and Family Connections by (referral source) because of concerns with his/her (adaptive/cognitive/communication/motor/ social-emotional development. Child and Family Connections is the regional system point of entry for the state's Early Intervention Services System. Early Intervention provides services and supports to infants and toddlers with developmental concerns and their families. Participation is voluntary.

As discussed, we will meet on (date) at (time and place) to begin the intake and eligibility determination process. I can be reached at (service coordinator phone number). I look forward to meeting you and your child.

Sincerely,

Service Coordinator

Enclosure:

  • Informational Brochure(s)
  • Rights Booklet

Updated: (06/07)