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Early Intervention

Early Intervention

Regional Early Intervention Collaborative (REIC)

The Mid-Jersey CARES (Collaboration, Advocacy, Resources, Education and Services) Regional Early Intervention Collaborative (REIC) is committed to providing a family-centered system of early intervention services and supports for families and their children with developmental delays or disabilities, ages birth to 3.

To make a referral to the New Jersey Early Intervention System (NJEIS) or for more information, please call the statewide toll-free number at 888-653-4463 or use the Electronic Referral Form below.

Check out Early Intervention’s Facebook page: https://www.facebook.com/MJCREIC

Early Intervention Referral Form

Please fill in the information to make a referral to NJ Early Intervention for an infant/toddler birth to 3. 

If you are making the referral on behalf of a child/family please make sure they have been made aware of the referral prior to completing this form.

First Name *
Last Name *
/
/
First Name *
Last Name *
ext Extension
If you are the parent/guardian, put N/A
First Name *
Last Name *
If you are the parent/guardian, put N/A
Please indicate the primary language of the parent/guardian
If you selected other, please write in the language below

Mid Jersey CARES REIC – Early Intervention Privacy Notice

The information you complete in this form is confidential and will only be disclosed to, used by, and distributed to the NJ Early Intervention System. A disclosure, use, or distribution of the completed information to anyone other than the NJ Early Intervention System will require the prior written permission of the child’s parent/guardian. The information in this form contains personal identifying information that is protected by law. This information is intended only for the use of the NJ Early Intervention System to call the parent/guardian back to discuss Early Intervention and/or completion of a child’s referral if the parent/guardian consents to move forward.

By checking this box, you are acknowledging that you either are the parent/guardian or the family has been made aware of the referral.

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