Client File

Chart Preparation

Access File Sheet (pdf)

Audit Checklist for Lehigh County (pdf)

Audit Checklist for Northampton County (pdf)

Audit Checklist for Berks County (pdf)

Audit Checklist for Montgomery County (pdf)

Client Intake (MSWord)

Communication Log (pdf)

Family Guided Routines (MSWord)

Folder Checklist (MSWord)

Labels for Folders-Print to Avery 8164 (MSWord)

Missed Session Log (pdf)

Satisfaction Survey (pdf)

Initial Session

Acknowledgement of Receipt of General Forms and Info (MSWord)

Blank Outcome (MSWord)

CIS Release of Information (MSWord)

Permission for TX-Generic (MSWord)

Permission for TX-SI-Cognitive and Language (MSWord)

Permission for TX-OT (MSWord)

Permission for TX-SLP (MSWord)

Permission for TX-PT (MSWord)

Policies (pdf)

Prescription for Services (MSWord)

Working Together Agreement (pdf)


Change in Service Request Form (MSWord)

Change in Service Request Form Protocol (MSWord)

Discharge/Transition Summary (MSWord)

Transition Resource for Families (pdf)

Progress Monitoring (LC/NC) (MSWord)

Progress Monitoring (LC/NC) (pdf)

NC Annual Summary Form (MSWord)

Electronic Session Note (MSWord)


Client Compliance Letter (MSWord)

Consult Form (MSWord)

Fax Cover Sheet (MSWord)

Transition Options by County (MSWord/Google Doc)

Signature form for TI sessions (MSExcel)

Smartphone Signature Video (MSWord/YouTube)


EI Session Note Guidelines (pdf)

Outcome Strategy Guidelines (pdf)

Ordering Session Notes (MSWord)

How to Turn Off Smart Quotes in Word (pdf)

Berks County Only

Consult/Change in Services Form-Berks (MSWord)

Quarterly Progress-Berks (MSWord)

Montgomery  County Only

Partnership Agreement (pdf)

Quarterly Progress-MontCo (MSWord)

Annual Meeting Procedures (pdf)

MA Assistance Consent Form (pdf)

IU Early Interventionist Transition Questionnaire (MS Word)

IU Early Teacher Transition Questionnaire (MS Word)

Spanish Forms

Spanish Satisfaction Survey (pdf)

Spanish Policies (pdf)

Working Together Agreement-Spanish (pdf)