Forms and Publications
Forms and Publications (English & other languages)
Tab/Accordion Items
- Assistive Technology Aging Out Letter
- Assistive Technology Care and Cleaning Instructions
- Assistive Technology Contact Letter
- Assistive Technology- Director Final AT Letter
- Assistive Technology Framework
- Instructions for Assistive Technology Framework
- AT Framework Example- Activity Chair
- AT Framework Example- Bionix Straw
- AT Framework Example- Compression Vest
- AT Framework Example- Gait Trainer
- AT Framework Example- Orthotics
- AT Framework Example- Stander
- AT Framework Example- Stroller
- AT Framework Example- Weighted Vest
- Assistive Technology Funding Authorization
- Assistive Technology Funding Checklist
- Assistive Technology Loan Agreement
- Assistive Technology Return-Transfer
- Assistive Technology Loan Request
- Assistive Technology Vendor Approval to Proceed
- Audiology Request for Funding
- Authorization to Disclose Health Info
- Authorization to Disclose Health Information for Research
- Biological Parent Notification Letter
- Confidentiality Agreement
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project Release
- Consent for Pyramid Model Practices Release
- Consent to Photograph & Video - Ongoing
- Declining Early Intervention Services
- Eligibility Determination Documentation
- Family Notification for Verification of Income
- FAQ Financial Review & Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection
- Financial Hardship Application
- IFSP Agreement horizontal
- IFSP Agreement vertical
- IFSP Review horizontal
- IFSP Review vertical
- IFSP horizontal format
- IFSP vertical format
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- Insurance Information Worksheet
- Intake Form
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- Monthly Summary Note
- Notice of Child & Family Rights
- Parent Handbook
- Policy-Procedure Acknowledgement Attestation Form
- Policy-Procedure Acknowledgement Attestation Form- Fillable PDF
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Referral Form
- Referral Update Form
- Reimbursement of Family Payments Made for IFSP Services
- Release Disclosure & Record Access
- Request for Mediation-Due Process
- Request for Restrictions on Use and Disclosure of Health Information
- Respite Reimbursement Authorization and Invoice
- Rights at Referral Letter
- Service Note & Billing Ticket_v.1
- Service Note & Billing Ticket_v.2
- Service Note & Billing Ticket_v.3
- Service Order Form
- Surrogate Parent Appointment Letter
- Surrogate Parent Identification of Need
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization and Invoice
- Working Together to Support Children's Learning and Development
- Assistive Technology Aging Out Letter
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology Loan Agreement
- Assistive Technology- Director Final Letter
- Authorization to Disclose Health Info
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project Video Release
- Consent for Pyramid Model Practices
- Consent to Photograph & Video - Ongoing
- Declining Early Intervention Services
- Family Notification for Verification of Income
- Filing a State Complaint
- Financial Data Collection
- Financial Hardship Application
- Financial Review & Hardship Adjustment FAQ
- IFSP Agreement horizontal
- IFSP Agreement vertical
- IFSP Review horizontal
- IFSP Review vertical
- IFSP horizontal format
- IFSP vertical format
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation Due Process
- Request for Restrictions on Use and Disclosure of Health Information
- Respite Reimbursement Authorization and Invoice
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization and Invoice
- Working Together to Support Children's Learning and Development
- Assistive Technology Care and Cleaning Arabic
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project Release
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development- Arabic
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project Release
- Consent for Pyramid Model Practices Video Release
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning Instructions
- Assistive Technology Contact Letter
- Assistive Technology- Director Final AT Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Info
- Authorization to Disclose Health Info (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph & Video - Ongoing
- Declining Early Intervention Services
- Developmental Milestones
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- Family Notification for Verification of Income
- Filing a State Complaint
- FAQ Financial Review and Hardship Adjustment
- Financial Data Collection
- Financial Hardship Application
- IFSP Agreement
- IFSP Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use and Disclosure of Health Information
- Respite Reimbursement Authorization and Invoice
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization and Invoice
- Working Together to Support Children's Learning and Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology- Director Final AT Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for ABC Video Ongoing
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Video or Photograph (Ongoing)
- Declining Early Intervention Services
- Developmental Milestones
- Early Childhood Transitions in North Carolina
- Filing a State Complaint
- Financial Data Collection Financial Form
- Financial Hardship Application
- FAQ Financial Review & Hardship Adjustment
- IFSP Agreement and Review
- IFSP
- Initial Evaluation- Not Eligible
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notice of Rights - Condensed
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use & Disclosure
- Respite Authorization Reimbursement Request & Invoice
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Teletherapy in the NC Infant-Toddler Program- For Families
- Texting Consent
- Transportation Authorization Reimbursement Request & Invoice
- Working Together to Support Children's Learning & Development
- Assistive Technology Care and Cleaning
- Assistive Technology Contact Letter
- Assistive Technology - Director Final Letter
- Assistive Technology Loan Agreement
- Authorization to Disclose Health Information
- Authorization to Disclose Health Information (Research)
- Biological Parent Notification Letter
- Consent for ABC Intervention Dissemination Project
- Consent for ABC Video Ongoing
- Consent for Infant Caregiver Project
- Consent for Pyramid Model Practices
- Consent to Photograph and Video- Ongoing
- Declining Early Intervention Services
- Early Childhood Transitions in NC
- Eligibility Evaluation for North Carolina Infant-Toddler Program
- FAQ Financial Review and Hardship Adjustment
- Filing a State Complaint
- Financial Data Collection Form
- Financial Hardship Application
- IFSP Agreement and Review
- IFSP
- Insurance Information Worksheet
- Mediation-Due Process Resolution Agreement
- Meeting Invitation
- Milestones
- NC ITP Step-by-Step
- Notice of Child & Family Rights
- Notification for Verification of Income
- Parent Handbook
- Prior Written Notice
- Prior Written Notice & Consent for Evaluation & Assessment
- Request for Mediation-Due Process
- Request for Restrictions on Use
- Respite Authorization for Reimbursement
- Rights at Referral Letter
- Surrogate Parent Appointment Letter
- Surrogate Parent Termination Letter
- System of Payments Notification
- Texting Consent
- Transportation Reimbursement Authorization
- Working Together to Support Children's Learning & Development
On This Page Jump Links
Off