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Ysician Note: An electronic version of this form may be found on the Division of Disability and Rehabilitative Services website at www.IN.Gov/fssa/q2328.htm. This document may be located at About DDRS and then under FORMS . Please complete the form, print, sign and return to the consumer to take to his/her local BDDS office. I CONSUMER INFORMATION Last name Middle initial First name City Street address (number and street) State ZIP code Indiana County of residence Date o.
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Gov FAQ
To minimize impact on individuals and families that result from the rate increases, BDDS will also increase the annual cap on the Family Support Waiver annual budgets from $17,300 to $19,614 when these are available in state systems beginning July 19, 2021, to ensure no loss in direct service.
Excluding Related content
Forms - FSSA: DDRS
Application for developmental disabilities services (state form 55068) · Confirmation of...
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