Early Intervention

Transitioning from Birth to 3 Program

Choose:
Birth-3 Interventionist Questionaire
Birth-3 Teacher/Caregiver Questionnaire

Please fill out the apppropriate form.

Child's Name *

First

Last

Child's Date of Birth *

Interventionist Name *

First

Last

Interventionist Email *

Interventionist Phone Number *

Date of Completion

Recent Progress (add descriptor)

Currently Working On (add descriptor)

Areas of Strength (add descriptor)

Areas of Concern (add descriptor)

Additional Information

Comment

The Pennsylvania Department of Education is responsible for law for providing early education services to eligible children age three (3) to school age in the Commonwealth. The Montgomery County Intermediate Unit 23, through an agreement with the Department of Education, is contracted to deliver those services in Montgomery County.

In order to become eligible for Early Intervention preschool services, children of this age group must exhibit
1) a developmental delay of 25 percent or a qualifying disability and
2) require specially designed instruction.