Developmental Educational Assistance Program

D.E.A.P.

Family Education & Support Forms

The following forms are intended for employee use only. Public forms may be accessed by clicking on this link.

Child Program Plan

Contact Sheet

    Definitions - Contact Sheet

Contract Form

Coordination Log

Cost Plan - IFES

DEAP Referral Form

Discharge Summary Form

Emergency & Other Skills Questionnaire

Fire Safety Questionnaire

IFSP

Initial Referral Form

Medical Appointment Record

Parental Prior Notice Letter

Part C, FES Cost Plan Form

Provider Statement of Confidentiality

Provider Timesheet Activity Log

Referral Form

    Referral Form Page 2

Request for Donated Funds

Resource Checklist

Service Agreement, Infant and Toddler (Part C)

Service Agreement, Intensive Family Education & Support

Connecting with individuals, families and communities.

 Adult Supported Living Services    Child Care Resource & Referral    Community Supports

Evaluation & Diagnosis Services    Family Education & Support    IDEA Infant & Toddler

In-Home Program    Lifespan Respite

PASARR    WIC