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First Steps of West Central Indiana

Referral Info

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Who is eligible? 
Children between the ages of birth and 3 who have an identifiable disability, are expressing a -2 SD (standard deviations below the mean) or 25% delay in one developmental area or a -1.5 SD or 20% delay in 2 or more developmental areas, or children who have a diagnosed medical condition that indicates the potential for a significant developmental delay.
 
Because First Steps completes a multi-disciplinary developmental assessment for every referred child, we'll "do the math" in finding out whether or not a child has a developmental delay and if so, to what extent.

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How do you make a referral?
You can download, fill in and fax one of the forms below or simply pick up the phone and call in a referral (and we'll fill out the paperwork).  You can reach the First Steps West Central office by calling 812-231-8337 or toll free, 1-877-860-0413.

Download a referral form in Word format.

Download a referral form in PDF format.

Download a Physician's referral form in Word format.

Download a Physician's referral form in PDF format.

First Steps of West Central Indiana
P.O.Box 4323
Terre Haute, Indiana 47804
 
Toll free:  1-877-860-0413
Toll free fax:  1-866-395-6034