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)
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…..
> 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).
> 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.