Intake

San Andreas Regional Center Intake Process

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Birth to Age 3: Early Start

Children under 3 go through Early Start, not SARC directly:

Santa Clara County: STARS

Monterey, San Benito, Santa Cruz Counties: Trumpet

No diagnosis needed; eligibility is based on developmental delays or risk.

Services start immediately.

Families receive an Individualized Family Service Plan (IFSP).

Age 3 and Older: SARC Intake

Families apply directly to SARC (online, email, or in person).

Eligibility covers:

Autism, intellectual disability, cerebral palsy, epilepsy

Other similar conditions starting before age 18 that cause substantial limitations

Children ages 3–4 may receive provisional eligibility while evaluations are completed.

Intake Process (All Ages)

Submit Intake Interest Form – starts the process; does not guarantee services.
Initial Interview – scheduled within ~15 working days; your information is documented.
Records Review – school, medical, psychological, and other reports are collected.
Assessment & Eligibility – SARC reviews all information; decision within 120 days.
Results
1. Eligible: assigned a service coordinator who makes a plan (IFSP for under 3, IPP for 3+).
2. Not eligible: referrals and appeal info provided.

Applicants Information

Date

Month

Day

Year

First Name

Last name

Date of Birth

Month

Day

Year

SSN:

Phone

Address

Is the applicant conserved

If yes, by whom:

Contact Person

Parent/Legal Guardian/Other:

Relationship to applicant:

Phone

Preferred Language:

Nature of Inquiry

To be considered eligible, a disability must have originated before the age of eighteen, be likely to continue indefinitely, and constitute a substantial disability. The eligible conditions are the following

(Please mark the applicable conditions under which you are applying):

Multi choice

Intellectual Disability: A disorder characterized by significant deficits in both cognitive albitites and adaptive functioning.

Cerebral Palsy: A neurological condition occurring from birth or early infancy resulting in an inability to voluntarily control muscular activity, and resulting in significant defects in motor adaptive functioning and/or cognitive abilities.

Epilepsy: A disorder of the central nervous system in which the major symptoms are seizures. Eligibility is based on a seizure disorder that is uncontrolled or poorly controlled, despite medical compliance and medical intervention.

Autism Spectrum Disorder: A syndrome characterized by impairments in social interaction (withdrawal, failure to engage in interaction with peers or adults), nonverbal communication skills, and ability to develop and maintain relationships. Individuals may engage in repetitive activities or a limited repertoire of activities.

Fifth Condition: This category includes disabling conditions found to be closely related to intellectual disability or requiring treatment similar to that required for individuals with intellectual disability.

Please note that conditions such as Attention Deficit Disorder, Learning Disability, & Language Disorders alone are not eligible conditions.

********* Once submitted, an intake service coordinator with contact you within 72 hours *******

Date Received

Month

Day

Year

Return Contact Date

Month

Day

Year

Signature

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