Intake Information


To set up an intake appointment, call Carol Wong at 503-262-4822.
Please bring the following information with you when you come for your Intake Meeting:

1. Referral Form
2. Current IEP
3. Eligibility Statement with Documentation: Academic, Psychological, Health Statement, Observations
4. Psychiatric (if available)

5. State Testing Results

6. Recent Progress Reports

7. Surrogate Parent Form (if applicable)

8. Immunizations

9. Functional Behavior Assessment

10.Behavioral Incident Records

 

 

 

 

 

 

 

 


© 2004-2011 Multnomah ESD, Mailing address is P.O. Box 301039, Portland, OR 97294-9039, 11611 NE Ainsworth Circle, Portland OR 97220, Phone: 503-255-1841, Fax: 503-257-1519
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