Apply for Services
MR/DD Services
CDDO manages the HCBS waiver for MR/DD (Mentally Retarded/Developmentally Disabled) services for individuals age 5 and older who meet certain qualifications. The first step is to apply for services. This can be done by completing the forms below this section. You may download and print them off at home, complete them, and mail or bring them in to our office.
If you are unable to do so, or need assistance to complete them, please contact our office so an application packet can be sent to you, and/or a time can be sheduled for you to come into our office.
A psychological evaluation may be needed for the individual requesting services. These can be completed at the Cowley County Mental Health and Counseling Center.
There may be other documents needed from doctors, hospitals, etc. Therefore a Release of Information is included in the documents below. Please fill this form out completely for any agency that may have important information needed in determining eligibility.
Please note there may be a waiting list to receive services.
Forms for MR/DD Services
Forms
Forms for MR/DD Services
- Application for MR/DD Services
- General Information
- Social History Questionnaire
- Release of Information
Release Form
Please make sure all forms are completely filled out.
When completing the Release of Information, you MUST fill in the name and complete address of the doctor, agency, or other entity the request will be going to. You may then send it to them yourself, or you can bring it to our office for us to deliver.
If information is needed from the Cowley County Mental Health and Counseling Center you will need to fill out one of their agency's Release forms. You may get one from them or request one from us.