ITC Online Referral

Infant & Toddler Connection of Fairfax-Falls Church


Welcome to the Infant & Toddler Connection of Fairfax-Falls Church (ITC). We provide early intervention services for infants and toddlers under the age of three years who have a developmental delay, atypical development or a diagnosis which commonly causes developmental delays. Parents contact us when they have concerns about their child's development. Our intake coordinator discusses the concerns and gathers information to better understand your concerns, and links you to a service coordinator. The service coordinator calls you to schedule a brief assessment. If your child is found eligible, a comprehensive assessment is scheduled with a team of therapists and a service plan is developed with your input. The plan focuses on what you want your child to accomplish and how activities in your family's everyday routines can be used to reach the specific goals for your child.

Anyone can make a referral to ITC.

ITC Online Referral Form

Referral Information
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Child Information
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Child's Gender (Required) *


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Jurisdiction (where the child resides) (Required) *




Parent/Guardian Information
Copy From Referral's Information

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Relationship to Child (Required) *





Further Information




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Thank you for your interest in the Infant & Toddler Connection of Fairfax-Falls Church Services.

Fairfax County is committed to a policy of nondiscrimination in all county programs, services and activities and will provide reasonable accommodations upon request. To request reasonable accommodations call 703-246-7121 or TTY 703-324-4495.

Please read the following before submitting.

I understand that submitting this Referral form does not guarantee that I will receive any services as there are eligibility requirements that must be met.



  



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