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State that you are requesting a special education evaluation. List any services your child has received or is currently receiving.State LAs and EIS providers should have clear and complete records that document the parent's decision to decline the evaluation or Part C. This team decides if there is evidence of a disability, if so, the areas to be evaluated and assessment to be completed. CT-SEDS User Manual – Referral and Evaluation. 1. The referral for therapy evaluation must include a signed order from the referring physician. First, complete the following referral form. Please allow for 30 days for us to complete the evaluation (45 for juvenile referrals). Eaton County Friend of the Court Referral Order. First, complete the following referral form.