Form Gci-1021 Forff - Individualized Family Service Plan (Ifsp)
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18ARIZONA DEPARTMENT OF ECONOMIC SECURITY
GCI-1021A FORFF (2-17)
(IFSP Packet)
Arizona Early Intervention Program (AzEIP)
This is the
INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP)
For
and Family
Interim IFSP
Initial IFSP
Annual IFSP
Date:
Service Coordinator:
Team Lead:
Our Mission – Early intervention builds upon and provides supports and resources
to assist family members and caregivers to enhance children’s learning and
development through everyday learning opportunities.
Equal Opportunity Employer/Program • Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the
Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act
of 1975, and Title II of the Genetic Information Nondiscrimination Act (GINA) of 2008; the Department prohibits discrimination
in admissions, programs, services, activities, or employment based on race, color, religion, sex, national origin, age,
disability, genetics and retaliation. To request this document in alternative format or for further information about this policy,
contact your local office; TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available upon request.
• Disponible en español en línea o en la oficina local.
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