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.

Build Up Michigan Referral Form

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 Andrea Martinez or 517.244.4514.

Do you need an interpreter?
Child Information:
MM/DD/YYYY
Child's Race  (required)
Child's Gender
This section is for Parent/Guardian contact information ONLY. There is no way for a district to contact a family without COMPLETE contact information.
Help for Parent/Guardian Primary Email Address The majority of communication is via email. By not including the PARENT/GUARDIAN email address, important communication may be missed.
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:
 


Contact Us

Michelle Nicholson
Executive Director, Early Childhood Services
747.226.4524
Build Up Michigan
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