Serving Anoka, Hennepin, Ramsey, Washington, Scott, Dakota & Carver Counties
Referral Submissions
EIDBI Referral Minnesota: Refer a Child for Care
Whether you’re a parent, pediatrician, school professional, or case manager, this form gets a child’s information directly to our clinical team so we can begin the intake process quickly and thoughtfully.
How Referrals Work
A clear starting point for every family
The details below help our clinical team understand a child’s current needs before we ever pick up the phone so that the first conversation is informed, not generic. Fields marked as specify-your-own give you room to add context our checkboxes can’t capture.
Once submitted, a member of our intake team reviews the referral, verifies insurance where applicable, and reaches out to schedule next steps, typically a CMDE evaluation if one isn’t already on file.
Who Can Refer
Who Can Submit an EIDBI Referral?
This form works for anyone starting the process, not just parents.
Whichever category you fall into, the same form and the same review process apply regardless of who submits it.
Eligibility
Who Is EIDBI Referral For?
EIDBI referrals are for children who may benefit from Early Intensive Developmental and Behavioral Intervention services, including children with developmental concerns or autism-related support needs.
Age and eligibility: EIDBI services are subject to applicable age, medical-necessity, and program eligibility requirements. Our team can help determine the appropriate next steps based on the information provided in the referral.
Service area: Elite Services Center serves families in Anoka, Hennepin, Ramsey, Washington, Scott, Dakota, and Carver counties from its Minneapolis office.
CMDE: A Comprehensive Multidisciplinary Evaluation (CMDE) may be needed to determine eligibility for EIDBI services. If a child already has a current, valid CMDE, our team can review the information and explain the next step in the treatment-planning process.
If you’re unsure whether a child is an appropriate fit, you can still contact our team before submitting the referral.
Referral Form
Please complete each section as fully as possible. Fields marked “please specify” give you space to add detail beyond the listed options.
This form is a design mockup and is not yet connected to a live submission system.
After You Submit
What happens next
Every referral is reviewed personally by our clinical intake team, not sorted automatically by a system.
01
Review
Our intake team reviews the referral details, including diagnosis, schedule needs, and insurance information.
02
Contact
We reach out by phone or email within one to two business days to introduce ourselves and ask any follow-up questions.
03
Verify
Where applicable, we verify insurance benefits so your family has a clear picture of coverage before anything is scheduled.
04
Schedule
If your child needs a CMDE, our team helps schedule the evaluation. If a current, valid CMDE is already on file, we can typically move forward with the next step in the treatment-planning process.
Referring on behalf of a family, not submitting for your own child? Include your name and role in the “Additional Notes” field so our intake team knows who to loop in alongside the parent.
Why Refer To Us
Why refer to Elite Services Center Inc
Service Area
Service area
We serve families across Anoka, Hennepin, Ramsey, Washington, Scott, Dakota, and Carver counties from our Minneapolis office.
Prefer to speak with someone directly first?
If you’d rather talk through a referral over the phone before submitting details in writing, our team is happy to help.