Early Intervention Provider Toolkit
Providers
- 2022-23 UF NCES Provider MOA
- 2021-22 UF NCES Provider Manual
- E-Verify Affidavit (notarization required)
- UF NCES Provider List
- 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 H – NCES Travel Reimbursement Guidelines
- Exhibit I – Consultation Form
- Exhibit J – Homeland Security Statement
- Exhibit K – MMA Plan Enrollment Summary
- Exhibit L – TPIN Plan Enrollment Summary
- Plan of Care
- AT Activity Based Assessment
- AT Recipt form
- AT Request
- UF NCES – IFSP Form
- Child Outcomes Summary Guidance
- Child Outcomes Summary Form
- ITDS Continuing Education Credits Form
- ITDS Recertification Form
Become an Early Intervention Provider
For more information on how to become a provider, contact Sharon Hennessy at hennesd@peds.ufl.edu.