APPENDICES FORMS Word Documents EI 5031 ATD Request EI ...
APPENDICES FORMS Word Documents EI 5031 ATD Request EI ...
APPENDICES FORMS Word Documents EI 5031 ATD Request EI ...
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THOMAS R. SUOZZI<br />
COUNTY EXECUTIVE<br />
DATE: / /<br />
TO: CPSE Chairperson<br />
NASSAU COUNTY<br />
DEPARTMENT OF HEALTH<br />
OFFICE OF CHILDREN WITH SPECIAL NEEDS<br />
Early Intervention Program<br />
Preschool Special Education Program<br />
Physically Handicapped Children’s Program<br />
60 Charles Lindbergh Blvd., Suite 100<br />
Uniondale, NY 11553-3683<br />
FROM: Early Intervention Program<br />
RE: Progress Notes<br />
ABBY J. GREENBERG, M.D.<br />
ACTING COMMISSIONER<br />
BOARD OF HEALTH<br />
Norma J. Henriksen Chair<br />
Diana Coleman Vice-Chair<br />
Ellen J. Braunstein, M.D.<br />
Donna Kass<br />
CHILD: CHILD DOB: / /<br />
With parental consent we have enclosed the most recent Early Intervention Progress Reports for<br />
the above named child.<br />
These reports are being sent to aid in planning for this child’s transition to the CPSE.<br />
In accordance with the Federal Educational Rights and Privacy Acts (FERPA) these records are<br />
confidential and may not be released to persons other than those authorized.<br />
Early Intervention Official Designee<br />
516-227-<br />
<strong>EI</strong>5243 3/07
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