FL Early Steps · Periodic and Annual Review Tool

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Administrative information

Child's full name

Date of birth

Medicaid #

IFSP date

Discipline

Authorization start

Authorization end

Session frequency

Visits authorized

Review completed date

Missed visits

Provider name

Service coordinator

IFSP review type

Periodic Review Annual Review

IFSP outcomes & benchmarks

Session notes

🔒 The child's name and Medicaid number are automatically replaced with initials before notes are sent for processing.

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Accepts .txt, .docx (Word), and .pdf files

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