Authorization Request Form. No information is available for this page.In-Home Supportive Services, also known as IHSS, can help pay for services if you're a low-income elderly, blind or disabled individual, including children. Both pages of the form must be given to the Caregiver to complete. Enclosed is a Caregiver's Affidavit. This document allows a Caregiver to enroll a child in school and consent to a child's medical care.