Child Find Referral Form - Lake Havasu Unified School District - havasu k12 az Preview on Page 1

Child Find Referral Form - Lake Havasu Unified School District - havasu k12 az 2026

The document is a Child Find Referral Form from the Lake Havasu Unified School District, intended for parents to report developmental concerns about their child. It collects essential information such as the child's name, birthdate, primary language, and specific developmental concerns including pre-academic skills, motor skills, and social skills. The form also requests details on any medical diagnoses or medications and requires parental consent to share the information with the Developmental Preschool at Smoketree Elementary.

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Definition and Purpose of the Child Find Referral Form

The Child Find Referral Form from the Lake Havasu Unified School District in Arizona is designed to assist parents and educators in identifying developmental concerns in children. The purpose of this form is to initiate a process that evaluates whether a child requires specialized educational support due to developmental delays. It is a crucial tool in ensuring that children receive the appropriate interventions and support services at a young age, which can significantly impact their educational journey and developmental outcomes.

Key Components of the Form

Child's Personal Information: This section collects essential details such as the child's name, birth date, and primary language, which helps in the identification and tracking of the referral process.
Developmental Concerns: Parents or guardians are prompted to describe specific areas of concern regarding the child's development, including pre-academic, motor, and social skills.
Medical Information: Any relevant medical diagnoses or current medications must be disclosed to provide a comprehensive understanding of the child's needs.
Consent to Share Information: The form requires parental consent to share personal information with the Developmental Preschool at Smoketree Elementary, ensuring that all privacy and legal requirements are met.

How to Obtain the Child Find Referral Form

To obtain the Child Find Referral Form from the Lake Havasu Unified School District, parents and guardians can visit the district's administrative office or access the form online through the district's official website. The availability of the form both physically and digitally ensures that all parents, regardless of their technological access, can initiate the referral process conveniently.

Where to Access the Form

Administrative Office: Available for pick-up during regular office hours.
Online: Downloadable version on the official Lake Havasu Unified School District website.

Steps to Complete the Child Find Referral Form

Completing the Child Find Referral Form involves several key steps:

Fill in Personal Information: Provide detailed information about the child, including name, date of birth, and language spoken at home.
Describe Developmental Concerns: Clearly outline any developmental issues observed in the child, such as difficulties in pre-academic, motor, or social skills.
Provide Medical Background: List any medical diagnoses or medications to ensure the child’s needs are fully understood.
Consent Section: Carefully read and sign the consent section to allow information sharing with relevant parties.

Detailed Instructions

Use Black or Blue Ink: Ensures clarity and legibility on paper forms.
Attach Additional Reports: If applicable, include additional documentation, such as previous assessments or reports from healthcare providers.

Eligibility Criteria

Eligibility to fill out the Child Find Referral Form is determined primarily by the child's age and the nature of the developmental concerns. Generally, children between the ages of three and five who exhibit signs of developmental delay or who have been previously diagnosed with such issues are eligible for referral. This eligibility allows the school district to focus resources and support on the children who need them the most.

Determining Factors

Age Range: Typically aimed at preschool-aged children.
Developmental Indicators: Concerns must align with district guidelines for developmental delays.

Legal Use and Compliance

The legal use of the Child Find Referral Form aligns with the U.S. Individuals with Disabilities Education Act (IDEA), ensuring that all children with potential developmental delays are identified and assessed thoroughly. Compliance with IDEA mandates that school districts actively seek out and evaluate children with disabilities to provide them with appropriate educational interventions.

Compliance Requirements

Adherence to IDEA: Ensures that all children in need are identified and supported.
Parental Consent: Legal sharing of information requires explicit parental permission.

Important Terms Related to the Form

Understanding the terminology associated with the Child Find Referral Form is crucial for accurately completing and submitting the form. Key terms include:

Developmental Delay: Refers to a child who is significantly behind peers in areas such as learning, moving, or interacting.
Individual Education Plan (IEP): A document developed for each U.S. public school child who needs special education.
Consent: Parental approval required for evaluating and sharing a child's information.

State-Specific Rules for Arizona

In Arizona, the Child Find Referral Process is guided by state-specific rules that complement federal IDEA regulations. These rules require school districts like Lake Havasu to conduct regular screenings and maintain records of developmental assessments and interventions.

Specific Rules

Screening Frequency: Regular intervals mandated by the state ensure early detection of potential developmental issues.
Documentation: Arizona requires comprehensive documentation of all referrals and assessments.