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You
may
contact Child Development Services by filling out the form below or
calling 207-781-8881. We welcome referrals from parents,
physicians, therapists, preschools or nursery schools. Please
note the parent/guardian of the child needs to be informed of the
referral and they must give verbal consent to have their child referred
to our agency.
Also,
keep in
mind that we ONLY service children with a legal
residence within Cumberland County (Maine) and are between
the ages of 0-5.* -- We have been assigned a catchment
area that includes the towns of; Cumberland, Falmouth, Freeport, Gray,
New Gloucester, No. Yarmouth, Portland, Pownal, Raymond, Sebago Lake
(the town of), So. Portland, Standish, Steep Falls, Yarmouth.
*(children
having a DOB after 10-15-2001 who were not eligible to enter the public
or private school system during their fifth year are eligible to
receive services with our agency). Children born on or before
10-15-2001 need to be referred to the Special Education Director of the
school district the child lives within - if you need assistance
locating this person and their phone number please call us at 781-8881.
Note
that once a referral is made we as an agency can only discuss the
child's case with the legal guardian and those listed by the guardian
on the 'release of information' form.
Child's
full
name
Child's DOB
Parent(s)/Guardian(s)
full name(s)
Home
Phone Work/Day
phone
Legal
address
Mailing
address
Name
of person
making referral (if other than parent.)
Contact
phone of
person making referral.
Brief
description of concerns/needs of child:
Has
this child
been seen at CDS-Cumberland (or Co-Step) in the past?
*Or
another CDS site:
*
Please call that site and request to have
your childs
records forwarded to our site.
Has
this child
ever had a developmental screening?
Type:
Has
this child
ever had an evaluation?
Type:
Evaluation agency name:
04-03-08
MP
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