Early Intervention Clearinghouse

Illinois Early Intervention Clearinghouse

The Illinois Early Intervention (EI) Clearinghouse identifies and collects research-based and best-practice early intervention information to share with families. Questions?...Just Ask

CFC FormsChild and Family Connections:
Forms for Working with Families

Select forms commonly used throughout the state of Illinois in Child and Family Connections (CFC) offices.

Non-Cornerstone Service Plan Pages

Forms and Samples from the Child & Family Connections Procedure Manual

[updated: 5/2013]

  • Acknowledgement and Notice of Social Security Disclosure
    English | Spanish
  • Acknowledgement of Receipt of Notices
    English | Spanish
  • Consent for Release of Information
    English | Spanish
  • Consent to Collect, Store & Utilize Personally Identifiable Information
    English | Spanish
  • Family Participation Fees Payment Agreement
    English | Spanish
  • Notice of Confidentiality Practices
    English | Spanish
  • Notice of System of Payments and Fees
    English | Spanish
  • Notice to Consent and Use Private Insurance
    English | Spanish
  • Notice To Consent to Use Private Insurance for Specific Service(s)
    English | Spanish
  • Notice to Use Public Benefits-Allkids Enrolled or Potentially Eligible for Allkids
    English | Spanish
  • Parental Consent and Ability to Decline Services
    English | Spanish
  • Screening Device for Determining Family Fees and Eligibility for AllKids & DSCC
    English | Spanish

Additional Documents

CFC Offices

Find the Child and Family Connections (CFC) office serving your county or zip code. The 25 CFC offices serve as the local contacts for the Illinois Early Intervention Program. Call the office in the region where you live to get started.



Who we are...

The Illinois Early Intervention Clearinghouse is operated by the Early Childhood and Parenting (ECAP) Collaborative at the University of Illinois. The EI Clearinghouse is funded by the Illinois Department of Human Services.

The Illinois Early Intervention (EI) Program provides a collection of services for families of children from birth to age 3 who have disabilities or developmental delays or who are at risk of having developmental delays. Families are the key to successful early intervention. Our mission is to provide families with the information they need to support their children's growth and development.


The EI Clearinghouse Web site provides families with access to an extensive early intervention library collection of books, videos, and journals. Some materials are available in Spanish as well as English.

The Web site also contains a newsletter for parents and links to other early intervention information intended for families.

EI professionals: We provide a list of videos approved for CEU credit as well as our library collection. Visit the Web sites of Provider Connections, the statewide network of (Child and Family Connections) CFC offices, and the Illinois EI Training Program.

Contact Us...

Illinois Early Intervention Clearinghouse
Early Childhood and Parenting Collaborative
University of Illinois at Urbana-Champaign
Children’s Research Center, Room 20
51 Gerty Drive
Champaign, IL 61820-7469

Toll free: (877) 275-3227
Local: (217) 333-1386

Web FormFor questions and material requests,
please complete our Online Request Form OR send us an email:

Learn more about the Illinois EI Clearinghouse.

The information provided on this Web site is not intended to take the place of either the written law or regulations. The opinions, resources, and links provided on the Web site are intended for information purposes only and are not intended to take the place of medical or legal advice, or of other appropriate services.

The content of the EI Clearinghouse Web site does not necessarily reflect the views or policies of the Illinois Early Intervention Clearinghouse, the University of Illinois at Urbana-Champaign, or the Illinois Department of Human Services; nor does the mention of trade names, commercial products, or organizations imply endorsement by the Illinois Early Intervention Clearinghouse, the University of Illinois at Urbana-Champaign, or the Illinois Department of Human Services.

University of IllinoisUniversity of Illinois at Urbana-Champaign
College of Education
Early Childhood and Parenting Collaborative

Illinois Early Intervention Clearinghouse
(877) 275-3227