CIS Early Intervention Test- Module 2 Question Title * 1. Your Name Question Title * 2. Email Address Question Title * 3. Region Addison/Middlebury Bennington Burlington/Chittenden Caledonia/St. Johnsbury Franklin Grand Isle/ St. Albans Lamoille/ Morrisville Orange/Hartford Orleans/Newport Rutland Washington/Barre Windham/ Brattleboro Windsor South/Springfield Question Title * 4. True of False - Schools and other primary referral sources are responsible for coordinating public outreach activities with the regional CIS/EI programs. True False Question Title * 5. True or False: The regional CIS/EI program is the single point of contact to receive referrals for children from birth up to three years of age who may be eligible for early intervention services. True False Question Title * 6. Scenario - At one of the WIC clinics, Ava's mom says she is worried that Ava (an 18 month old girl) is not talking as much as her older brother Ben did when he was the same age. The WIC nurse asked if she has talked to her doctor about this concern. She has not. True or False: The WIC nurse must get written consent first from Ava's mom in order to send a referral to the regional CIS/EI program. True False Question Title * 7. Select best response to complete the sentence. Hospitals, physicians, schools and other primary referral sources shall refer a child to the regional CIS/EI program as soon as possible and no more than ____ days after identification. 10 5 7 None of the above. Question Title * 8. Please select the best response. Public awareness for Part C means: Regional CIS/EI programs are partnering with primary referral sources in the community. There are approved materials to promote the services in the community. The primary referral sources (your partners and families) know how to make a referral (who to contact, when and why). All the above. Done