**Call the Information Line at (608) 663-8471 if you need assistance in completing the form and when making an immediate referral to evaluate your child for Special Education.

 

Private/Parochial School: If you are the parent of a child enrolled at a private/parochial school within Madison, you may contact your child's teacher or school administrator for intervention information. Check the MMSD Private/Parochial webpage for more information.

Early Childhood Request for Assistance

For Preschool Children within the Madison Metropolitan School District.

The first step in this process is gathering information about the child by filling out the form below. This information is important for us to have whether you would like a Child Find screening or are making a referral for Special Education. It is essential that you make every effort to provide detailed information in the request form.

If you are requesting an immediate referral, please complete this form and call 608-663-8471.

* items must be completed

If we do not receive detailed information, an email will direct you to resubmit your request for assistance.

Child's Information
Parent / Guardian Information
Information About Person Making Request
Childcare / Preschool Information (if applicable)
Child Concerns & Information

For each item checked above, please fax reports to 608-204-0349, Attn: Christine Tormey.

After you have submitted your request and it has been processed, you will receive followup paperwork in the mail. This paperwork will be sent to the child's family.