How might I request?

Change in Service Request Form (please review Protocol)

Link to video for completing a change in service request 

Samples of Change in Service forms for Additional Service: SI Request for OT, SI Request for SLP

Sample of Change in Service form regarding Service Frequency: Request for Decreased Services

Complete the WHOLE form (including plan to decrease service).

Submit in Provider Soft using the fillable form and it will be reviewed by Admin and then sent on your behalf to the applicable Service Coordinator.

How do I complete a consult?

Consult Instructional Video 

A consult is requested to determine if additional services are indicated for SLP, OT, teachers or PT, or to provide families and the other team members with professional expertise.  The consulted service is expected to have a beginning and end, providing guidance and strategies to the existing team, and is not intended as a segway for adding additional services.

In MC Consults are typically requested at the quarterly meeting during service plan changes. The Service Coordinator should communicate what they desire from the consult.  Once the consult is assigned, E-mail members of the existing team and do your best to schedule the sessions with the applicable existing provider(s) and Service Coordinator.  The consult typically takes 1-2 hours and may occur over multiple sessions, being sure to adhere to the number of units approved. 

You are expected to complete/write-up your consult within your session time(s).  

You must fill out a session note in Provider Soft (and possibly this supplemental Consult Form if you need additional writing space) in Provider Soft. 

Each consult report should include the following components:

1.  Date of consult                                

2.  Description of what was observe

3.  Developmental Levels

4.  Strategies for family to use within the routine

You may use an evaluation tool specific to the child’s needs (i.e., HELP, DAYC-2, Sensory Profile). 

Please only put % delay and strategies on the consult form or session note. DO NOT write on the form whether services are warranted. It is up to the SC to make the determination if services will be added (typically services will be added if an applicable delay is noted) or you may state "Informed clinical opinion" if standardized testing does not show a delay.  Upload to PS and CIS will send the consult form to the SC, but feel free to also E-mail the SC if you wish to discuss finding not included on the form.  If you were consulted as part of the Collaborative Model, be sure to provide the family with recommendations for carryover during your evaluation session and contact the other team members to provide them with your feedback after the evaluation.  If regular services are approved after a consult, the child must be seen for their initial visit within 14 days of the approval date.  Also, the SC may ask for your help writing a goal statement.  

Sample of supplemental consult write-up: OT

It is important for existing providers to encourage consulting therapists to spread out the time they are seeing the child when given a consult. There is flexibility when units are given and they give a start and end date for this reason.  The consult can be spread out to ensure strategies are being implemented by the family.  Example: 8 units given- Therapist may use 4 units week 1 and 4 units week 3 in the month.  A session note should be completed for each session.