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The IFSP Form

The Nebraska Department of Health and Human Services has prepared a 14 page form (called EI-1) to guide the preparation and documentation of the IFSP. This form documents the efforts of families and professionals to identify and meet the developmental needs of infants and toddlers with disabilities and their families. It is a written plan for the provision of early intervention services. Click on each box below for an explanation of how the page should be used.

Complete 14-page set of forms (EI-1) in PDF format.
(Spanish) Complete 14-page set of forms(EI-1) in PDF format.
(Vietnamese) Complete 14-page set of forms (EI-1) in PDF format.

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Form

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Instructions

Description

Early Intervention Program
Concerns and Priorities Instructions
Child and Family's Strengths
Child's Present Levels of Development
Child's Present Levels of Development (Cont'd)
Child's Present Levels of Development (Cont'd)
Goals and Outcomes
Goals and Outcomes (Cont'd)
Services
Services (Cont'd)
IFSP Transition Plan
IFSP Transition Plan (Cont'd)
Child/Family Team Signatures
Parent Signature
 
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