This video provides information on how to complete the intake forms for Santa Clara County Early Start. If you view this video on Youtube, you can click on a time to jump to just the forms you may questions about, or just scroll through the video to find the form you have a question about if you view it here.

0:52 Online Appointments for Support with Intake Forms

1:01 How to get the Packet of Forms?

1:47 Intake Data Form

3:54 Content of the Packet of Forms

4:21 Cover Letter from Lead Agencies: San Andreas Regional Center and Santa Clara County Office of Education

5:47 Break and tips

6:28 Form #1 Intake Form

8:03 Form #2 Early Intervention Family Assessment

9:16 Form #3 Passbook Medical and Developmental History

11:16 Form #4 Authorization of Exchange/HIPAA (mandatory)

13:20 Form #5 ASQ:SE-2 Developmental Milestones Screening Tool

15:00 Break and tips

15:39 Returning the Packet of Forms

16:13 What happens after I return the Packet of Forms?

17:09 Contact numbers and emails for Early Start Program and Parents Helping Parents