REACH Partnership

If your child is being assessed through the Learning Solutions Hampshire or Franklin County REACH Partnership, please complete the following four forms and upload a copy of your child’s insurance card:

 

Insurance Cards and Important Documents Upload

Please Upload Clear Pictures of the FRONT & BACK of the Client’s Insurance Card(s) and Scanned Copies of Other Important Documents (each document MUST be a single file. PLEASE DO NOT UPLOAD LARGE DOCUMENTS ONE PAGE AT A TIME (e.g., IEP/504 Plan, previous psych testing, hospital discharge summaries, etc.).

 

Required Forms

Personal Information Form

Reach Pre-3 History Form

HIPAA/Multiple Consent Form

Authorization for the Exchange of Information Form

 

 

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