Provider Documents For King County Early Intervention Program

Please refer all questions regarding the policies to Jan Wrathall using the contact information at the bottom of this page. For information about accessing documents in pdf format, please see this King County help file.

Policies and Instructions

• Extraordinary Expenses Funding Policy and Request Form Instructions
• Hearing Aid/FM System Funding Policy (pdf)
• Policy for Payment for Early Intervention Services (pdf)
• Case Management Information System - County Human Resources Information System Form Instructions | Definitions (doc)

Forms

• Extraordinary Expenses Request Form (excel spreadsheet)
• Payer of Last Resort Worksheet (pdf)
• Technical Assistance Request/Work Order (pdf)
• Self-Assessment Tool for Washington's Infant Toddler Early Intervention Program (pdf)

Sample Forms

• Example Hearing Aid Invoice (pdf)
• Autism Example: Extraordinary Expenses Request Form (pdf)
• Hearing Aid Example: Extraordinary Expenses Request Form (pdf)
• Birth-To-Three Revenue and Expenses Report (Excel)

You can also request a Hearing Aid Invoice or the Extraordinary Expenses Request Form by contacting Holly Bell.