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Early Intervention Family Rights & Procedural Safeguards Forms

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Procedural Safeguards Notice

Procedural Safeguards Notice, Open DOCX file, 81.17 KB (English, DOCX 81.17 KB)

Prior Written Notice (2017)

Prior Written Notice - English, Open PDF file, 145.11 KB (English, PDF 145.11 KB)
Prior Written Notice - English (Accessible), Open DOCX file, 262.99 KB (English, DOCX 262.99 KB)
Prior Written Notice - Spanish, Open PDF file, 141.71 KB (English, PDF 141.71 KB)
Prior Written Notice - Spanish (Accessible), Open DOCX file, 258.26 KB (English, DOCX 258.26 KB)
Prior Written Notice - Portuguese, Open PDF file, 145.86 KB (English, PDF 145.86 KB)
Prior Written Notice - Portuguese (Accessible), Open DOCX file, 259.45 KB (English, DOCX 259.45 KB)
Prior Written Notice - Arabic, Open PDF file, 172.98 KB (English, PDF 172.98 KB)
Prior Written Notice - Arabic (Accessible), Open DOCX file, 265.22 KB (English, DOCX 265.22 KB)
Prior Written Notice - Haitian Creole, Open PDF file, 148.3 KB (English, PDF 148.3 KB)
Prior Written Notice - Haitian Creole (Accessible), Open DOCX file, 270.69 KB (English, DOCX 270.69 KB)
Prior Written Notice - Vietnamese, Open PDF file, 246.28 KB (English, PDF 246.28 KB)
Prior Written Notice - Vietnamese (Accessible), Open DOCX file, 72.45 KB (English, DOCX 72.45 KB)

Consent for Evaluation and Assessment (2017)

Consent for Evaluation and Assessment - English, Open PDF file, 133.42 KB (English, PDF 133.42 KB)
Consent for Evaluation and Assessment - English (Accessible), Open DOCX file, 59.85 KB (English, DOCX 59.85 KB)
Consent for Evaluation and Assessment - Spanish, Open PDF file, 130.27 KB (English, PDF 130.27 KB)
Consent for Evaluation and Assessment - Spanish (Accessible), Open DOCX file, 56.2 KB (English, DOCX 56.2 KB)
Consent for Evaluation and Assessment - Portuguese, Open PDF file, 135.97 KB (English, PDF 135.97 KB)
Consent for Evaluation and Assessment - Portuguese (Accessible), Open DOCX file, 59.26 KB (English, DOCX 59.26 KB)
Consent for Evaluation and Assessment - Arabic, Open PDF file, 139.99 KB (English, PDF 139.99 KB)
Consent for Evaluation and Assessment - Arabic (Accessible), Open DOCX file, 60.98 KB (English, DOCX 60.98 KB)
Consent for Evaluation and Assessment - Haitian Creole, Open PDF file, 155.84 KB (English, PDF 155.84 KB)
Consent for Evaluation and Assessment - Haitian Creole (Accessible), Open DOCX file, 66.78 KB (English, DOCX 66.78 KB)
Consent for Evaluation and Assessment - Vietnamese, Open PDF file, 230.29 KB (English, PDF 230.29 KB)
Consent for Evaluation and Assessment - Vietnamese (Accessible), Open DOCX file, 60.23 KB (English, DOCX 60.23 KB)

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