Reason for Referral

Complete the Reason for Referral screens.

1. Select the reason or reasons for referring this child.

Reason for referral screen with option for developmental delay screening or medical condition

2. If you select Developmental Delays, check the specific area(s) of concern. Click the Save and Continue button.

Reason for referral - developmental delays areas of concern

3. If you select Standardized Developmental Screening(s), check the instrument(s) that were administered and enter the date of administration. Click the Save and Continue button.

Reason for referral - standardized screening instruments

4. If you select Identified Medical Condition, check the specific medical condition or check Other and enter a description of the other medical condition. Click the Save and Continue button.

Reason for referral - identified medical conditions

5. The Additional Details screen will appear.

Maryland Infants and Toddlers Program Online Referral System

Reason for Referral