Materials Request & Contact Form | Illinois Early Intervention Clearinghouse

Use the form below to request materials and for general inquiries.

Note that only residents within the state of Illinois may request materials.

Name *

Email *

Phone *

Street Address *

City *

Zip code *

The Illinois county you live in: *

Of the following, which best describes you? *

Materials being requested or your question/comment: *

If you are requesting specific titles, it is helpful if you can provide both the title and the call number.

Are you a real person filling out this form? *

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