Thank you for your referral!
STEP 1
Refer Only If You Have the Following For the Individual ...
Approved Budget
Most current approved budget and any amendments in progress
DDP2
Must be completed with scores
Year To Date Expense Report
The most current monthly budget summary highlighting what's been used and what's left.
CR-4
Used to verify individuals demographic information.
FI or Broker Termination Form
Must be signed by the participant/designee, old broker and Fiscal Intermediary as needed.
Staff Action Plan
If Community Habilitation service is in the budget
***Additional documents will be requested once I accept the case
STEP 2
Have all the necessary documents?
If you have all the required documents mentioned above, that's great news! Please send me an email that contains the first name of the participant, their parent's name, their county/borough, and phone number. Also, make sure to include the designee in the email. After receiving your email, I'll respond to it, and the designee can decide on a suitable time for us to connect and get to know each other. This way, we can determine if we're a good match and move forward accordingly.