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SDOC 4K Registration
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Child's Last Name
Child's First Name
Child's Middle Name
Child's Date of Birth
Child's Home Language
If you chose other, what is the child's home language?
Has your child ever received early intervention services?
School District Pre-school Intervention Program (PIP)
Child's Pediatrician/Family Doctor
If yes, please bring your child's medicaid card to your appointment. If not, parent/guardian will need to bring proof of income (W2/current pay stub).
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