New Jersey § 30:4-25

§ 30:4-25.

a. Notwithstanding any law to the contrary, an individual who may be eligible for

early intervention services pursuant to P.L.1993, c. 309 ( C.26:1A-36.6 et seq. ), functional services through the Division of Developmental Disabilities in the Department

of Human Services pursuant to Title 30 of the Revised Statutes, or if the individual

is developmentally disabled and may be eligible for special educational services pursuant

to chapter 46 of Title 18A of the New Jersey Statutes, shall make an initial, uniform

application for the determination of eligibility for services with the department

responsible for providing the services being requested at the time the application

is made. In the case of a request for early intervention services, an initial application

shall be made when a referral for an evaluation of the child is made. In the case of a request for special educational services, an initial application

shall be made at the time a child study team conducts the initial evaluation. b. The initial application shall contain: the name, address, telephone number and

Social Security number of the applicant; relevant family information; the types

of services requested or provided to the applicant; and a consent provision authorizing

release of the initial, uniform application to a department, as applicable to the

request for subsequent services. The disclosure of the applicant's Social Security number shall be voluntary and

shall be requested pursuant to the federal Privacy Act of 1974, Pub.L. 93-579. c. The initial application shall be accepted and used by all the departments enumerated

in this section, as authorized by the applicant's consent, for each subsequent request

for the provision of services. With each subsequent request for service, the respective department may ask the

individual to provide updated information or additional information on specific developmental

delays or medically diagnosed mental or physical conditions that is necessary to determine

the individual's eligibility for the specific services requested.