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Early On Referral Form
Thank you for contacting Early On of St. Clair County. All information provided will be kept confidential. The family referred for services will be contacted by an Early On staff member from St. Clair RESA within 10 calendar days of submission of this form.
If you have questions about the online referral process, please call (810) 455-4398.
How did you find out about us?
Department of Human Services
Child Care Provider
Date of birth (mm/dd/yyyy)
School district where child currently resides
American Indian or Alaskan Native
Black or African American
Native Hawaiian or Other Pacific Islander
Two or more races
Hispanic of any race
Was the child premature?
Provide a detailed description of the child's concern/reason for referral.
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This form was created inside of St. Clair County RESA.