Connecting children and youth with needed services in the community does not have to be time consuming and confusing for families and providers.
How can practices get started?
1. Bright Futures Implementation – Clinical Practice page – From the American Academy of Pediatrics Bright Futures website, a guide to help implement Bright Futures recommendations through and updated “Tips to Link Your Practice to Community Resources”
2. Many communities have come together to simplify the referral and intake process for common services letting one form or process do the work of many. We welcome other nominations to add to the list below:
Better Health Together Region (Counties: Adams, Benton, Franklin, Grant, Kittitas, Walla Walla and Yakima)
Who Do I Contact to Refer a Child for an Evaluation? Form
Two-sided chart provides guidance on the appropriate public health Children and Youth with Special Health Care Needs (CYSHCN) and Early Support for Infants and Toddlers (ESIT) contact people for each county and advises faxing both the CYSHCN Coordinator and ESIT Partner based on the child’s address.
Cowlitz County
Cowlitz County Early Learning Referral Form
The Cowlitz County Early Learning Coalition came together to find a common process for getting services to families. They developed a common form listing developmental, educational and support services of interest to parents and children. Parents/guardians note any current agencies they are already working with and can check any services they are interested in learning more about. The referring agency submits the form to a central agency and all the agencies a family is interested in learning about will contact the family.
Grays Harbor and Pacific Counties
Developmental Referral Form (English)
Developmental Referral Form (Spanish)
Common Developmental Referral Form developed to help a child and family get needed developmental and support services.
Whatcom County
Whatcom Taking Action website and Single Entry Access to Services (SEAS) Referral Form
“Whatcom Taking Action for Children and Youth with Special Healthcare Needs” is a consortium of community organizations, including the local health department, working together to improve the local system of care for children and youth with special needs. The collective aim is that each family experiences coordinated family-centered care and support, regardless of their point of entry.
The Single Entry Access to Services (SEAS) Line was developed to help families and providers find assessments and other services for children and youth with special needs. Please call SEAS at 360-715-7485 for concerns about any child in Whatcom, birth to 21. Providers can fax referrals to SEAS at (360) 676-6729.
Whatcom County Applied Behavioral Analysis (ABA) Intake Form, ABA List of Providers and What is ABA
Whatcom Taking Action brought together the four ABA agencies in the county and worked with them to develop a common application that families would only have to fill out once for all the agencies.
There is now one ABA Intake Form to fill out for all Whatcom County ABA service providers. Families no longer have to fill out different lengthy intake forms for each ABA provider. If your child has a diagnosis of Autism Spectrum Disorder (ASD), OR if s/he is on a waiting list or has an appointment for an autism evaluation, you can fill out this one form and make copies to send to any/all of the Whatcom County ABA providers to get on their waiting lists.
