Vermont Official State Website

Documents

File Name Filesort descending Category Date File Format
Report a Concern PDF icon Report_a_Concern_Page.pdf 18 Apr 2016 PDF
Attendant Services Program Brochure PDF icon Attendant_Services_Program_Brochure.pdf 18 Apr 2016 PDF
Adult High Technology Agreement for Care Form PDF icon Adult_High_Tech_Agreement_For_Care.pdf Form 18 Apr 2016 PDF
CFC 805A Home-Based Service Plan PDF icon CFC 805A HB Service Plan Updated for 2_23_16 MCD Bump_ICD_10.pdf Form 18 Apr 2016 PDF
CFC 804 Home-Based & ERC Change Form PDF icon CFC_804_HB_ERC_AFC_change_report.pdf Form 18 Apr 2016 PDF
Case Management Standards & Certification Procedures PDF icon Case_Management_Standards _Technical Edit 1_.pdf 18 Apr 2016 PDF
CFC 805A Home-Based Service Plan PDF icon CFC_805A_Home_Based_Service_Plan_7_1_15.pdf Form 03 May 2016 PDF
CFC 809 Emergency Contacts & Backup Plan PDF icon CFC_809_Emergency_Contacts_&_Backup_Plan.pdf Form 03 May 2016 PDF
CFC 811 High Needs Wait List Follow-Up Form PDF icon CFC_811_High_Needs_Wait_List_Follow-up_Sheet.pdf Form 03 May 2016 PDF
Employer Certification Form PDF icon Employer_Certification.pdf Form 04 May 2016 PDF

Pages

Contact Us

Megan Tierney-Ward, Division Director
HC 2 South, 280 State Drive
Waterbury, VT 05671-2070
Voice: (802) 241-0294
Fax: (802) 241-0385
For Telecommunications Relay Service: Dial 711

Connect with Us
Limited English Proficiency (LEP)

RSS

This is a Division of the
Department of Disabilities, Aging and Independent Living
under the Agency of Human Services