Pediatric Primary Care

Development and Behavior

Referrals and Services

Referral SmartPhrases

Additional resources/information

ADHD

General Resources

ADHD Encounter Form
Information for families (Plain Language Pediatrics - bilingual)
Suggested cardiac screening before starting ADHD medication

Medication management

Vanderbilt Scales

Parent initial screen (bilingual, Spanish first)
Teacher form with return instructions (English only)
Parent follow up (bilingual, Spanish first)
Teacher follow up
Teacher request/return cover letter
Scoring instructions

Adult ADHD Symptom Checlist

Autism

Early Start

IEP, 504, Educational Support

Overview: Connecting patients to schools for support
Provider-driven letters for families to take to schools/districts

Authorization for communication (include with all requests)
Request for copy of evaluation/IEP/504 Plan
Request for school assessment/support
Request for evaluation (speech)
Sample letter to support 504 plan

504 Accommodations (examples, PA State Education Association)
Parent handout on IEP process
Sample parent letter to request IEP/evaluation
School District Contact List

IHSS

Information and resources for families

Home Strategies for Supporting Development

Surrey Place Language Strategies
ASQ Intervention Activities
Help is in Your Hands - online videos for famillies of young kids with social communication challenges

Early Start

Early Start information for families (simple/contact)
Early Start Map to Services (bilingual)

Community Early Learning Resources

Program information (bilingual, RWC, EPA, Mountain View)

Community-based therapies

Contact information

Quick Links

ASQ Intervention Activities (link to folder)

Surrey Place language resources

Family Advocacy Program Referral

Developmental Services - Contact Summary

Connecting kids to Early Start and School (training file)