Rceb referral 2026

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The document is a referral form for the Early Start Program at the Regional Center of the East Bay, designed to support children with developmental disabilities in Alameda and Contra Costa Counties. It outlines the process for obtaining parental consent for referrals, provides sections for personal and medical information about the child, and details eligibility criteria for early intervention services. The form emphasizes the importance of consent and includes instructions for submitting relevant documents.

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Click ‘Get Form’ to open the rceb referral in the editor.
Begin by filling in the 'Referral Source' section with the name of the agency or individual and their contact number.
Ensure that you provide verbal or written consent from the parent or legal guardian. This is crucial for processing the referral.
Complete the child's personal information, including their name, date of birth, and social security number.
Fill out the medical and birth information section, detailing any complications and relevant medical history.
In the 'Current or Prior Services' section, list any agencies involved with the child and attach necessary documents as indicated.
Finally, review all sections for accuracy before submitting your completed form through our platform.

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