General Forms

• Developmental Services Application Form (November 2003)

• Developmental Services Waiver Eligibility Form (January 2004)

• Developmental Services Emergency Fact Sheet (January 2004)

Critical Incident Reporting

• Critical Incident Report Form (December 2003)

• Critical Incident Report for Restraint Form (December 2003)

Individual Support Agreement

• Individual Support Agreement Basic Form (December 2003)

• Individual Support Agreement Required Approvals Form (December 2003)

• Individual Support Agreement Review Form (December 2003)

Local System of Care Plan

• Local System of Care Plan: Instructions for the 3-Year Plan FY 2005 - FY 2007

Mandatory Disclosure of Information

• Mandatory Disclosure of Information to Home Providers and Respite Workers Form (January 2004)

• Guidelines for Completing the Mandatory Disclosure of Information to Home Providers and Respite Workers Form (January 2004)

• Home Provider Mandatory Disclosure Law Implementation Questions and Answers (January 2004)

Alternatives to Guardianship - Appointing a Health Care Agent

A 2005 change to the Vermont law on health care decision-making makes it easier for a person with developmental disabilities to appoint a health care agent. DDAS has drafted a simplified form to assist individuals who simply want to appoint a health care agent.

• Appointing a Health Care Agent for People with Developmental Disabilities Cover Memo

• Health Care Agent Disclosure Statement and Appointment of My Health Care Agent Form

Return to Forms Home Page