Build Up Michigan

Build Up Michigan is for children ages 3-5. If you are concerned about your child or a child you know who may not be meeting important developmental milestones, complete the Referral Form below to begin the evaluation process. Services are FREE and coordinated through the school district where the family resides-even if the child is not yet attending school.

Provide COMPLETE parent/guardian info below. Without complete contact info, we have no way to contact a family, which significantly delays processing. For questions, please contact Teri' Pete at 517.541.8937.

Do you need an interpreter?
Child Information
Child's Race
Child's Gender
What school district do you reside?
Has this child ever received any services such as Early On, Speech, Occupational or Physical Therapy?
This section is for Parent/Guardian contact information ONLY. There is no way for a district to contact a family without COMPLETE contact information.
Preferred Contact Method
If you are NOT the parent/guardian making the referral, please list your contact information as follows:
Does the family know you are making a referral?
Security Check - To verify you are not a robot, please answer this question:
 


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