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LICA (Low Incidence Cooperative Agreement) serves students who are deaf or hard of hearing from age 3 through 21. We are a public school special education cooperative with 44 member school districts in the north and northwest Chicago suburbs. LICA provides diagnostic services, classroom instruction, itinerant support, and related services to our districts’ schools and their students and families.


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NSSED > LICA > For District Staff > Referring Students to LICA
 
 
   

The LICA Referral Form displayed here may be completed online and then printed.  Gather all required signatures before you mail or fax (847/803-9480) the referral to Julie Sander, LICA Diagnostics Support Specialist.

The descriptions on page 2 of the form explain Item VI: Services Being Requested. Questions? Please contact Julie Sander at LICA.

Please  note, this form is not for parent or student self-referral.  It is for school district use only.

 

 

 

If you are referring a student for an Auditory Processing Disorder Consultation, please download and complete the LICA APD Packet, as well as completing the LICA Referral Form.

LICA, 1601 Feehanville Drive, Suite 400, Mount Prospect, IL 60056-6016, Tel. 847.803.9444 © LICA 2010