Forms

General

• Authorization Form for Use of Disclosure of Protected Health Information
• CDDO Area Transfer Form
• COVID-19 Medical Form Printable
• COVID-19 Medical Form Fillable
• Critical Incident Report
• Dispute Resolution: Affiliated Providers Disputes with the SCDDO (A-04)
• Eligibility Handbook
• ES-3161
• Home and Community Based Services MR/DD Medicaid Waiver Consumer Choice Form
• Intake Packet - Age 6 and Under
• Intake Packet - Age 7 and Older
• KanCare Application
• Policy Manual
• Provider Directory
• Relias New User Form
• SCDDO Consumer Information Changes
• SCDDO Payment Guidelines
• Service Changes Form
• What is the SCDDO?
• F102 Termination Cover Page

Fast Facts

• Appeals
  • Spanish
  • Vietnamese
• Becoming a Service Provider
• Community Resources
  • Spanish
  • Vietnamese
• Eligibility
  • Spanish
  • Vietnamese
• Functional Assessment
  • Spanish
  • Vietnamese
• Funding Committee
  • Spanish
  • Vietnamese
• Initial Intakes
  • Spanish
  • Vietnamese 
• Notice of Funding Eligibility
• Options Counseling
  • Spanish
  • Vietnamese
• PASRR
• Project SEARCH General
• Project SEARCH Sedgwick County
• Youth Transitions to Adulthood

Funding Committee

• Funding Resources
• Notifications/Updates

Functional Assessment

• Functional Assessment Cover Page
• BASIS 6.0 Manual
• Behavior Tracking and Definitions

Quality Assurance Committee

QAC Manual

• QAC Manual

Service Review Documents

• BSP and PMP Plan/Documentation Review
• BSP and PMP Plan/Documentation Review Comments
• Personal Care Services for Children Tool
• Personal Care Services for Children Tool - Fillable
• Personal Care Services for Children Tool - Fillable (Spanish)
• Personal Care Services for Children Tool - Pandemic
• Employment Questionnaire
• Life Enrichment Tool
• Life Enrichment Tool - Fillable
• Life Enrichment Tool - Pandemic
• Support Plan Review
• Support Plan Review Comments
• Residential Tool
• Residential Tool - Fillable
• Residential Tool - Pandemic
• Personal Care Services for Adults Tool
• Personal Care Services for Adults Tool - Fillable
• Personal Care Services for Adults Tool - Fillable (Spanish)
• Personal Care Services for Adults Tool - Pandemic
• Work Services and Supported Employment Tool
• Work Services and Supported Employment Tool - Fillable
• Work Services and Supported Employment Tool - Pandemic

Forms

• HIPAA in BASIC TRAINING
• HIPAA Basic Acknowledgement Form
• QAC Cover Page
• QAC Review Checklist
• SCDDO Non-Employee Confidentiality Form
• Self-Direction Notification Letter

Templates

• Agency Intervention Plan Template
• Individual Service Modification Plan Template