Get ready to apply
Hawaii Department of Health, Children with Special Health Needs Branch
Hawaii Early Intervention Services
What you get
Help finding early-intervention services for your child’s development or special health needs. Ask whether requests are open.
- Who starts it
- You
- How it’s sent
- PDF form, sent the way they ask
- Your time
- About 30 minutes
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Your child is 3 or under.
- Services and transportation must be part of the IFSP.
-
What their form asksA preview, so you can gather things first. Fill it in on their site.
Open the application PDF ↗ Checked Aug 27, 2026What the form asks for
Published intake questionsReferral Source Name / relationship / contactChild’s NameDate of BirthLegal GuardianshipArea(s) of ConcernDiagnosis / ICD CodeDevelopmental and/or Medical ConcernsScreening/Assessments DonePrimary Caregiver Name(s) / RelationshipChild’s Residence AddressPhone number / best call timeAdditional CommentsParent/Legal Guardian Signature
After you send
Confirm receipt and respond to any eligibility or verification request. If you have not heard back in two weeks, write and ask whether it arrived.