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Initial Phone Call

Timelines Important to Note: (Clock starts ticking from initial referral)

▪ Referral Assignment (From ACT office is sent to Service Coordinator)

▪ Initial Phone Call-should occur within 48 hours of receipt of referral

▪ Initial Visit/Screening-within 10 days of receipt of referral

▪ Eligibility Evaluation-no more than 30 days from receipt of referral

▪ If Eligible, Child and Family Assessment Visit and

▪ Initial IFSP MUST be completed within 45 CALENDAR days from referral date

● Describe AzEIP and ACT; referral process

● Explain team-based early intervention services for infants and toddlers and the Key Principles of Early Intervention (use your card)

● Talk about screenings; evaluation, transition and IFSP

● Find out the family's concerns

● Find out if any screening and/or evaluation was completed.

● Verify child's correct date of birth (prematurity)

● Schedule initial visit with family (if family wants to proceed)

● Let families know that there are no cost to the family for screenings, evaluation, and development of IFSP; but there may be a cost for ongoing services and that you can discuss that later

● Describe what happens at the initial visit (see Initial Visit)

● Remind parents to have copies of evaluation/medical records (if applicable) available for the visit that they would like to share.

● Always verify address for the visit

● Update the AzEIP Child's Data Form Referral and Demographic

● When trying to contact the family, always call at different times/different days.


Documentation and Forms Used

● Initial Phone Call Dialog

● Initial Visit summary form

● Service Coordinator Contact Log

● Referral Letter:

o Letter sent to the referral source

● Follow-Up Letter:

o Sent to the referral source when the team member cannot contact the family.

● Unable to Process Letter:

o Sent to the referral source when the team member does not have enough information to contact family (wrong phone number; number disconnected)

No Contact Letter:

o Letter sent to the family when team member cannot contact family.

Script for Initial Phone Call

Hi parent/guardian’s name. This is ACT team member’s name. I’m with Arizona Cooperative Therapies with the Arizona Early Intervention Program (AzEIP).  I received a referral for child’s name. Is this a good time to talk?


If yes, a good time to talk:

  • Ok great, again my name is __________. I am a discipline with ACT, which is a part of AzEIP. We provide early intervention services to infants and toddlers and their families.

  • The early intervention services includes: screenings and evaluations to determine eligibility; and ongoing services for children who are eligible.

  • I understand you have some concerns about child’s name. The information I received stated you have concerns with:______________. Please tell me more about your concerns…..

  • Discuss/explain:

> Key Principles of Early Intervention

> Early intervention

> AzEIP is a voluntary program

> No fees for screening and evaluations; but may be for ongoing services.

  • We are a home-based program that provides team-based early intervention (explain team base).

  • Next steps…..

> Ask the family if they would like for you to come out and explain EI more and complete a screening. Schedule a visit.

> If the family is not interested, let the family know that they can always contact the AzEIP again at anytime.


If no, not a good time:

  • Ask the family when would be a good time and number to call back. Or, give the family your contact information to have them call you back.

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