ADMINISTRATIVE |
POSTING DATE |
| Change of Information/RAU Transfer Form |
February 29, 2024 |
| Change of Information/ RAU Transfer Form - INSTRUCTIONS |
June 2, 2022 |
Practitioner Confirmation Form  |
February 20, 2025 |
Practitioner Confirmation Form Instructions  |
February 20, 2025 |
Prior Approval for E-A Services PCF  |
March 5, 2025 |
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AT/AUDIOLOGICAL |
POSTING DATE |
Clarification of Process for Identifying and Accessing Assistive Technology Service
Original posting date: July 1, 2017 - REVISION DATE: February 15, 2022. |
May 8, 2023 |
| AT Equipment Loan Agreement |
February 29, 2024 |
| Assistive Technology, Audiological Services and Interpreter Service Authorization Request Form |
February 29, 2024 |
| Assistive Technology, Audiological Services and Interpreter Service Authorization Request Form - SAMPLE |
June 17, 2024 |
| Assistive Technology Assessment Form |
February 29, 2024 |
| Assistive Technology Service Authorization Checklist |
June 17, 2024 |
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COMMUNICATION LOGS |
POSTING DATE |
| Correspondence/Phone Contact Log |
May 29, 2024 |
| Missed Appointment Documentation |
February 29, 2024 |
| WVBTT Prescreen for COVID-19 |
February 29, 2024 |
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|
IFSP |
POSTING DATE |
| Authorization for Team Units and Documentation of Transition Conference Form |
May 29, 2024 |
| Authorization for Team Units and Documentation of Transition Conference Form - INSTRUCTIONS |
October 14, 2022 |
IFSP - Individualized Family Service Plan  |
September 3, 2025 |
| Individualized Family Service Plan INSTRUCTIONS |
November 10, 2022 |
| IFSP
- Additional Page |
February 29, 2024 |
IFSP Child Outcome - Additional page 
IFSP Child Outcomes in Child Care Routines - Additional page  |
February 18, 2025
February 18, 2025 |
| IFSP Family Outcome - Additional Page |
February 29, 2024 |
IFSP Review 
| January 21, 2025 |
Teaming Activity Note
|
February 29, 2024 |
| Teaming Activity Note - INSTRUCTIONS |
|
COSF-Decision Tree For Summary Rating Discussions
|
March 5, 2025 |
2.0 Definition of Developmental Delay 
|
May 1, 2025 |
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INTERVENTION ACTIVITY NOTES |
POSTING DATE |
| Intervention Activity Note |
February 29, 2024 |
| Intervention Activity Note - Instructions |
October 5, 2022 |
| |
|
RECORD REQUESTS |
POSTING DATE |
| Service Coordinator Request to Release Child Records |
February 29, 2024 |
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|
REFERRAL/INTAKE |
POSTING DATE |
| General Referral Form for WVBTT |
March 13, 2025 |
| |
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SERVICE COORDINATION ACTIVITY NOTES |
POSTING DATE |
| Service Coordination Activity Note |
October 13, 2022 |
| Service Coordination Activity Note - INSTRUCTIONS |
October 5, 2022 |
|
|
TRANSITION |
POSTING DATE |
EXIT- Child Outcome Summary Form (COSF)  |
September 29, 2025 |
| EXIT- Child Outcome Summary Form (COSF) - INSTRUCTIONS |
June 8, 2022 |
| Transition Checklist |
February2 9, 2024 |
| Transition/Exit Form |
February 29, 2024 |
| Transition/Exit Form - INSTRUCTIONS |
June 2, 2022 |
| Transition Plan |
February 29, 2024 |
| WV Birth to Three Transition Summary Update |
February 29, 2024 |
| |
|
OSC/ISC RESOURCES |
POSTING DATE |
| Assistive Technology-DME Vendors Listing |
July 7, 2023 |
| Audiological Service Providers Listing |
February 8, 2024 |
| Daily Family Routines Handout |
February 29, 2024 |
| Documentation Submission Chart |
August 4, 2022 |
| Parent Letter of Request for Part B Services |
|
| Procedural Safeguards Notice |
June 2, 2022 |
| Procedural Safeguards Notice - Spanish |
June 2, 2022 |
| State Complaint Brochure |
August 8, 2024 |
| State Complaint Form |
July 17, 2024 |
| The Components of Functional, Meaningful Child Outcomes |
June 2, 2022 |
| Transition Cheat Sheet |
June 2, 2022 |
Transition Resource Information 
|
June 5, 2025 |
| Vision Service Providers Listing |
July 7, 2023 |
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ADDITIONAL FORMS |
POSTING DATE |
Application for Over-Ride of Denied Claim  |
July 14, 2025 |
| WV BTT Request for Forms/Brochures |
December 16, 2024 |
| SSA-DDS Contact Form |
Febraury 29, 2024 |
WVBTT Photo Release Form  |
August 6, 2025 |
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