Child and Family Connection Office

Helpful Information

Service Coordinator Community of Practice (SC CoP)

Developed by EITP in collaboration with system stakeholders:

• DEC SC CoP web conversation on coaching as a Service Coordinator
• Coaching Families through EI (developed by EITP)
• A Journey through EI (companion tool for families)

Waiver and Exemption PowerPoint

CFC Agency Listing

Correcting Errors in Cornerstone

CFC Fax Cover Sheet Instructions

Key for Central Billing Office Insurance Benefit Verification Form

Requirements for Submitting a Pre-Billing Waivers Request

Downloads/Forms

• CFC Fax Cover Sheet for Insurance Requests – Fax cover sheet for CFCs to use for insurance requests.
• Assistive Technology Approval Request Form
• Insurance Affidavit Form – Child and Family Connections Insurance Affidavit, Assignment and Release.
• Insurance Change Notification Form – Child and Family Connections Change of Insurance Notification.
• Insurance Exemption Form – Child and Family Connections Insurance Exemption Request.
• Insurance PB Waiver Form – Child and Family Connections Insurance PB Waiver Form.
• Tax Savings Account Information Sheet – Child and Family Connections Tax Savings Account Information Sheet.
• Notice to Consent and Use Private Insurance Health Care Plan Benefit – Child and Family Connections Notice To Consent and Use Private Insurance For Specific Service(s) Form.
• Acknowledgement to Decline Exemption – Child and Family Connections Acknowledgement To Decline Exemption For Tax Savings Account and Individual Plan Forms.

PowerPoint Presentation Videos:

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