Documents
- CBO Billing Document
- Child and Family Connections (CFC) Procedural Manual
- Consultation Verification Form
- Credential Extension Request Form
- Early Intervention Program – Acknowledgement of Supervisor
- EI Provider Handbook (Revised 2022)
- Evaluator Report Format
- HIPAA Compliance Infographic
- Illinois Early Intervention Program Referral Fax Back Form
- Ongoing Professional Development Documentation Form
- Ongoing Professional Development Documentation Plan Format
- Provider Connections Credit Tracking Template
- Request for Duplicate Documents
- Standardized Illinois Early Intervention Referral Form
- Updated List of Assessment Tools
Copy of Background Check Needed for Child Care
If a provider needs a copy of a background check to provide services in a child care setting, a request can be made to Provider Connections. Keep in mind and let the child care setting know that we are authorized to conduct a State Only fingerprint, not an FBI fingerprint. The fingerprint can only be released to the provider, not the child care setting or the provider’s employer, however the employer may pay for the cost of processing.
A $10 processing fee is charged as it is for all requests for duplicate documents. To access the request for duplicate documents, go to https://providerconnections.org/, select Resources, then Provider Connections Documents. Select Request for Duplicate Documents and complete the form. If you wish to pay by check, print the document and mail it with the check to the following address:
Provider Connections
Western Illinois University
1 University Cir
20 Horrabin Hall
Macomb iL 61455
Illinois Early Intervention Systems of Support Infographic
Learn more about the systems that support Illinois Early Intervention in this interactive graphic that highlights the key stakeholders that work together to support children and families in Illinois Early Intervention, by exploring an overview of who they are, what they do, where to find their key resources, and how to contact them. This tool is a great reference for anyone new to early intervention! https://eitp.education.illinois.edu/Files/Resources/EIGraphic/index.html