Do you have concerns about your preschool-aged child's development?                                                
Services are available to help children (ages 3-5) with significant delays. A developmental screening is the first step in determining if a child qualifies for services.

Child Find can provide a FREE screening in the areas of:  Fine and Gross Motor Skills, Speech and Language, Cognitive Skills, Social/Behavior, and Adaptive/Self-Help Skills.

If a child's developmental screening shows that their skills are delayed compared to their typically developing peers, a more comprehensive assessment may be recommended. 
 
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Child's Name: 
Child's Date of Birth:
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DD
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YYYY
Person making screening request: 
Does your child have any documented disabilities or diagnoses? 
What are the areas of suspected disability (please mark all that apply)? 
Additional information you'd like to share about concerns for your child's development? 
Parent/Guardian Name(s)
Do you require an interpreter? 
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Does your child require an interpreter? 
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Home Address: 
Phone Number
Home Language: 
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Thank you for completing the Eastmont School District Screening Request Form.  Please expect a phone call from Eastmont Early Learning staff within 5 school days to schedule a ChildFind appointment.
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