Consultations and Forms


Below is a list of everything you should bring to a Deeming Waiver consult.

                ** Note:  You won't have all of these, this is a general list.                      No worries.  Just bring what you have.


1)   Psychological Evaluation 

2)   Developmental Pediatrician Evaluation 

3)   Specialists Letters or Evaluations

4)   IEP 

5)   IFSP

6)   Therapy Assessments (for each therapy your child has)

7)   Medical Records (If you have any on hand)

8)   Hospital Records (If you have any)

9)   A Photo of your child (that I can keep)

10)  Copy of your child's birth certificate (Doesn't have to be certified)

11)  Copy of your child's SS Card

12)  Copy of your Insurance Card (both sides) 

13)  Completed Intake Form

      

     There are more things you will have to put together.  I will go over those       when we meet.  I look forward to helping you help your child!

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Forms


The Intake Form is a Word Document.  It may be opened, filled in, and printed.  Or, you can print it and fill it in by hand.  Please bring it to our initial consult.


Intake Form


The Application for Benefits Forms are to be filled out by the parents and must be completed as if they were the child.  These forms can be printed and filled out and brought with you to the consult meeting.


                                              Application for Benefits 


The Social History is a document that you will have to write and include in your packet to Medicaid.  Below are instructions and an example of a Social History to help you when writing yours.  If possible, bring it to our initial meeting.  If you don't have time to do it prior to our initial meeting, you can email it to us later.


                                                  Social History