Referral Process

Eligibility

To be eligible for Diagnostic Center assessment services, the following eligibility criteria should be reviewed:

  • Student is between the ages of 3 and 21 years old.
  • The student is receiving public education services within the thirteen counties in DCC’s region
  • The student must be enrolled in a special education program, where the student
    • is making inadequate progress, or
    • presents a complex and/or low incidence disabling condition, or
    • presents a complex behavioral and/or learning profile
  • The LEA requires additional diagnostic information to assist in defining the most appropriate educational goals and teaching strategies
  • The LEA has utilized available resources to address the student’s needs; however; questions/issues remain unanswered, including issues regarding special education eligibility
  • Referral issues are not more appropriately addressed by an agency other than the educationally focused services of the Diagnostic Center (i.e., Regional Center or Department of Mental Health).

Referral Application Packet

Students must be referred to the Diagnostic Center by their local educational agencies (school district or county office of education).

The referral application includes two parts or forms:

  • Part I: District Information;
  • Part II: Parent Information.

Both of these forms, along with all of the required information included on the front page of the district and parent forms, are required. District personnel should complete the “District Information” form and the parent/legal guardian should complete the “Parent Information” form. If any portion of the packet is incomplete, it will result in the delay of the assessment. The initial referral should include the following:

  1. A completed application packet (District & Parent) specifying district/parent concerns. diagnostic questions to be addressed and district attempts at remediation
  2. The most current Individualized Education Program
  3. The results of the most current evaluation (reports older than 2.5 years will not be accepted)
  4. Release of information forms (HIPAAs) dated and signed by parent. One HIPAA is to be completed per provider. It is important that all information be filled out completely to include the name and address of the clinic, hospital, organization or agency
  5. Authorization by LEA Director of Special Education or designated special education administrator (signature confirms district has exhausted local resources)
  6. Authorizing parent signature (signature authorizes the referral)

Referral Application

Referral Application Form(PDF)
The referral application and records are screened by an admissions review committee to determine completeness of the referral package and to determine acceptance of the referral. The local education agency and parents are contacted regarding the recommendations of the admissions committee and an assessment date is scheduled.