Early Intervention Provider Toolkit

For Early Intervention Providers

• 2021-22 UF NCES Provider MOA
• 2021-22 UF NCES Provider Manual
• 2021-22 Provider Meeting Presentation – COS
• 2021-22 Provider Meeting Presentation – Fiscal
• 2021-22 Provider Meeting Presentation – IFSP and Policies
• 2021-22 Provider Meeting Presentation – NCES Updates
• Exhibit A – Service Initiation Form
• Exhibit B – Monthly Progress Note
• Exhibit C – Discharge Summary Form
• Exhibit D – Procedural Safeguards
• Exhibit E – Statement of Understanding
• Exhibit F – Service Fee Schedule
• Exhibit G – Combo Form
• Exhibit G – EI Claims Form
• Exhibit G – Therapy Claims Form

• Exhibit H – In-State Travel Form – Community Providers
• Exhibit H – In-State Travel Form – EXAMPLE ONLY
• Exhibit I – Consultation Form
• Exhibit J – Homeland Security Statement
• Exhibit K – MMA Plan Enrollment Summary
• Exhibit L – TPIN Plan Enrollment Summary
• UF NCES Provider List
• AT Activity Based Assessment
• AT Recipt form
• AT Request
• Plan of Care
• UF NCES – IFSP Form
• Child Outcomes Summary Guidance
• Child Outcomes Summary Form

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For Interpreters

• 2021-22 UF NCES Interpreter MOA
• 2021-22 Business Associate Agreement
• Exhibit A – Procedural Safeguards
• Exhibit B – Statement of Understanding
• Exhibit C – Homeland Security Statement
• Exhibit D – Interpreter Claims Form
• Exhibit E – In-State Travel Form