Important Highlights for the Completion of DD Form 2792-1

“Special Education/EarlyIntervention Summary”

MCCS Camp Allen EFMP Office

• DD Form 2792 must be completed for all EFMP enrollees.• DD Form 2792 (and DD Form 2792-1, if applicable) are also the forms used when

updating EFMP paperwork every three years, when the condition changes, or the EFM needs to be otherwise disenrolled (per MCO 1754.4B).

• Please be sure to use the most current version of the form, which has “DD Form 2792, APR 2011” on the bottom of the pages.

• If the EFM is a child, regardless of age, a DD Form 2792-1 must also be completed and submitted with the DD Form 2792. (Please see the other set of instructions for the completion of DD Form 2792.)

For EFM’s birth to age three, please check “YES” or “NO” in section 5. If the EFM’s age is up to age three and no early intervention services are received and the child does not have an Individualized Family Services Plan (IFSP) OR if your EFM is homeschooled, then only Page 2 will need to be completed and signed by the sponsor or spouse.

DD Form 2792-1Page 2

For all other school-aged EFM’s, the sponsor (or spouse) will need to complete Page 2, sign the bottom of Page 2, AND the EFM’s school official will need to complete and sign Page 3.

DD Form 2792-1Page 2

The sponsor or spouse must sign and date here to authorize the release of the EFM’s information.

The school official must complete the rest of Page 3.

Upon completion of Page 3, the school official must complete all of section 8 and sign and date the bottom of Page 3.

DD Form 2792-1Page 3