We know your time is valuable and limited, so we have provided this method of opening a case for your convenience. As always, if you have any questions about opening a case or need assistance in completing the referral forms below, please call ELI at 591-0170 and we will help you.

 

 

Provider/Teacher/Director: To open a case you may access these referral documents, which are in PDF format. Download them to your computer and print them out:

• Cover Sheet
    
• Parent Information Sheet for the Parent to keep
    
• Parent Consent for the Parent to fill out and return to the Provider/Teacher
    
• Provider Survey, to be completed by the Provider/Teacher
    
• Behavioral Checklist, to be completed by the Provider/Teacher

 

Once all forms have been completed and signed (as applicable), please return them to ELI via mail or fax per the information below:

Behavioral Consultation Project

c/o Kathleen Kelley or Denise Abbott at ELI

311 Professional Center Drive, Suite 100

Rohnert Park, CA 94928

(fax: 707.591.0171)

When ELI receives the paperwork back, we will call you to confirm receipt, request any missing information, and update you with assignment information. Cases are assigned within two business days of receiving the completed paperwork.
   

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