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Patient Information

ICD evaluations are designed to identify your child’s strengths and challenges in order to formulate accurate diagnoses and to make recommendations regarding necessary therapeutic and/or educational interventions. A parent or guardian is required to be present for all evaluations. Evaluations, depending upon which type, can last approximately 1 to 2 hours. The parent or guardian will be asked to provide child’s history and discuss areas of concern. Since personal and sometimes sensitive information may be discussed during this interview and also during the time we relay pertinent evaluation information back to you at the end of the evaluation, it is recommended that if possible you bring someone else with you to supervise your child in our waiting/playroom at those times. 

To ensure that the professionals evaluating your child have all the information they need to best help you and your child we are requesting parent/guardian provide the following information (required prior to scheduling an appointment): 
  • New Patient Questionnaire or Returning Patient Questionnaire [required prior to obtaining an appointment for a Developmental Pediatric Study]
  • Release Form
  • Vanderbilt Assessment Scale [only for children ages 3 and older]
  • Copy of your child’s IFSP [Individual Family Service Plan] if your child receives Early Intervention Services
  • Copy of your child’s IEP [Individual Education Plan] if your child receives special education services within his/her school program
  • If your child has had any standardized testing within the past year, copies of the evaluation or if unavailable, names and dates of tests completed is required as validity of standardized testing measures may be compromised if repeated within a 12-month time frame
Completion of a Hearing Test is required prior to scheduling a Speech-Language Evaluation. To schedule an appointment at Hackensack UMC Audiology Dept., please call 551-996-5337. 
Your child’s teacher should complete the following information (which can be sent in advance or brought with you at time of evaluation):
  • Vanderbilt Assessment Scale-Teacher Informant [only for children ages 3 and older]
  • S.I.F.T.E.R. [only for children ages 6 and older]
  • Classroom Teacher’s Statement
On the day of your evaluation please remember to bring the following:
  • Any required paperwork, not already submitted
  • Assistive devices, as appropriate for your child, including glasses, hearing aids, orthotics and augmentative communication aids
  • For Physical and Occupational Therapy Evaluations please have your child wear or bring to change into: a pair of shorts or leggings and sneakers
So that the full amount of time required to complete the evaluation is available for you and your child it is essential that all appointments be kept at their scheduled times. Registration prior to your evaluation may take 5-10 minutes so please keep this in mind when you plan your arrival time at the medical center. Parent/guardian must bring personnel identification and the child’s insurance card. Notice of at least 24 hours is requested if you must cancel any scheduled evaluation.  Please call our Intake and Appointments office if you need any additional information or need to cancel or reschedule your appointment at 551-996-5555 and follow the voice prompts which will direct your call to the appropriate staff member based upon your inquiry. 
Pre-evaluation paperwork may be submitted by:
  • Mail to Appointments Office, Institute For Child Development, Hackensack UMC, 30 Prospect Ave. Hackensack, NJ 07601
  • Fax to 551-996-5034                      
One of our appointment coordinators will reach out to schedule your requested evaluation upon receiving your completed paperwork. 



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