Joint Screening Referral Consent Form

This form is part of the referral packet that agencies must submit with a child’s referral to Chicago Public Schools for a full and individual evaluation. The consent form is completed by agency staff reviewed with and signed by parents to allow the process to proceed. Click here to download the form in English.

This form is part of the referral packet that agencies must submit with a child’s referral to Chicago Public Schools for a full and individual evaluation. The consent form is completed by agency staff reviewed with and signed by parents to allow the process to proceed.

Click here to download the form in Spanish.

Get The FormGet The Form
Contact your assigned DFSS Supervisor for this resource.