Child and Student Education Referral Form

Notice: Due to COVID 19, all local school districts and Early On programs are working remotely to provide supports until face to face services can resume. Please fill out the referral form and be sure to include a phone number and email so you can be contacted by the appropriate staff.

    Please provide the following contact information

    Please provide a detailed description of child

    For questions call (734) 334-1393.

    This form is intended for children attending Wayne County schools or living in Wayne County ONLY.