A completed enrollment packet including a medical assessment from the child’s pediatrician is required in order to place a child in a Bell Center program. To download the enrollment packet, click on the links below.

For questions concerning enrollment, contact the Program Director, Betty Bell, at (205) 870-0081.

Bell Center Application

Click on each page to print out.

1. Bell Center Application

2. Emergency Medical Authorization Form

3. Full Release and Waiver of Liability

4. Photo release

5. Statement of Understanding

6. Medical Assessment

Complete all pages and return to:

The Bell Center for Early Intervention Programs

1700 29th Court South

Birmingham, AL 35209

Attn: Betty Bell