South Central BOCES
Early Childhood Special Education Department

To request an evaluation of your child or student, please click on In-School Referral Form below and follow these steps.

1. Save the referral form to your computer
2. Fill out the form and save the completed document on your computer
3. E-mail the completed form, as an attachment, to referral@sc-boces.org  OR fax to the attention of Early Childhood Special Education Department at 719-647-0136
4. For more information please contact the South Central BOCES Early Childhood Special Education Department at 719-647-0023 x124

In-School Referral Form (MS Word document)

NOTE: email is typically not secure so please do not include any privacy related information