Forms

The following forms are used during the Vermillion Early Childhood Screening Process:

• Referral for Developmental Learning Concerns (completed by Head Start, Daycares, and other referring parties)
• Health & Developmental Overview (completed by the parent(s) and brought to the screening appointment)
• Consent & Release of Information (completed at the screening appointment to give permission)

You can download, print, and complete the forms OR pick up blank copies in the Austin School office to fill out. Given the length of the Health & Development Overview form, we strongly encourage it to be completely filled out before arriving at the screening. Please download them below.

Please be as honest and thorough on these forms as you can be. Every bit of information helps us make an informed recommendation for next steps. All forms are completely confidential and are kept with the child's screening file at Austin School.