Page1: Cover sheet instructions

Two important blanks are on the third line down:

Date of Referral to Early Intervention

The date the parent or another primary referral source first contacts a public agency to inquire about services. This is important because this starts the 45 day time line.

and

Date of Consent for Evaluation

The date the parent signs the consent for the child's special education initial multidisciplinary evaluation.

In the middle of the Cover Sheet is an area labeled Parent(s)/Guardian. Here the name of the parents, guardian, foster parents, and HHS foster care worker (if applicable) should be filled in, with their role identified.

Three-forths of the way down the page is a line that says, "If you have any questions about this plan of any of the people working with your child, please call the person listed as Services Coordinator." Below this are important spaces for the Name, Phone, and Agency/Address of the Services Coordinator.

Near the bottom of the form, note the spaces labled ISFP Meeting Dates:
Here are spaces to record the Dates/Date Sent for the Interim, Initial, Annual, and Transition IFSP meetings.

Finally, at the bottom of the page are spaces to record the Dates/Date Sent for each of the Periodic Reviews.