Early Intervention/early Childhood Special Education (Ei/ecse) Referral Form For Providers* Birth To Age 5 Form (Page 3 of 4) in pdf

Early Intervention/early Childhood Special Education (Ei/ecse) Referral Form For Providers* Birth To Age 5 Form Page 3

Early Intervention/Early Childhood Special Education (EI/ECSE) Referral Form for Providers* Birth to Age 5

OREGON EI/ECSE CONTACTS

Douglas County

Lake County

Sherman County

Baker County

Phone: 541.440.4794

Phone: 541.947.3371

Phone: 541.565.3600

Phone: 800.927.5847

Fax: 541.440.4771

Fax: 541.947.3373

Fax: 541.565.3640

Benton County

Lane County

Gilliam County

Tillamook County

877.589.9751

800.925.8694

Phone: 541.565.3600

Phone: 503.842.8423

Phone: 541.753.1202 x106

Phone: 541.346.2578

Fax: 541.565.3640

Fax: 503.842.6272

Fax: 541.926.6047

Fax: 541.346.6189

Clackamas County

Grant County

Lincoln County

Umatilla County

Phone: 503.675.4097

Phone: 800.927.5847

Phone: 541.574.2240 x106

Phone: 800.927.5847

Fax: 503.675.4205

Fax: 541.265.6490

Linn County

Clatsop County

Harney County

Phone: 541.753.1202 x106

Union County

Phone: 503.338.3368

Phone: 541.573.6461

877.589.9751

Phone: 800.927.5847

Fax: 503.325.1297

Fax:

541.573.1914

Fax: 541.926.6047

Columbia County

Hood River County

Malheur County

Wallowa County

Phone: 503.366.4141

Phone: 541.386.4919

Phone: 541.372.2214

Phone: 541.426.7641

Fax: 503.397.0796

Fax: 541.387.5041

Fax: 541.372.2214

Fax: 541.426.3732

Marion County

Coos County

Jackson County

Warm Springs

888.560.4666

Phone: 541.269.4524

Phone: 541.494.7800

Phone: 541.553.3241

Phone: 503.385.4714

Fax: 541.269.4548

Fax: 541.494.7829

Fax: 541.553.3379

Fax: 503.435.5922

Crook County

Jefferson County

Wasco County

Morrow County

Phone: 541.269.4524

Phone: 541.693.5740

Phone: 541.296.1478

Phone: 800.927.5847

Fax: 541.382.3901

Fax: 541.475.5337

Fax: 541.296.3451

Washington County

Curry County

Josephine County

Multnomah County

English: 503.614.1446

Phone: 541.269.4524

Phone: 541.956.2059

Phone: 503.262.4100

Spanish: 503.614.1263

Fax: 541.269.4548

Fax: 541.956.1704

Fax: 503.262.4109

Fax: 503.614.1290

Deschutes County

Klamath County

Polk County

Wheeler County

Phone: 541.312.1195

Phone: 541.883.4748

Phone: 503.435.5940

Phone: 541.565.3600

Fax: 541.382.3901

Fax: 541.850.2770

Fax: 503.435.5922

Fax: 541.565.3640

Oregon EI/ECSE contact information also available at

Yamhill County

Phone: 503.435.5918

Fax: 503.435.5922

or contact 1-800-SafeNet

For questions or corrections about this form, contact the

Oregon Public Health Division, Office of Family Health:

molly.emmons@state.or.us

or 971-673-0234

This EI/ECSE Referral Form may be duplicated and downloaded at

Form Rev. 06/20/2012

Early Intervention/early Childhood Special Education (Ei/ecse) Referral Form For Providers* Birth To Age 5 Form Page 3

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