Brochures
Program brochures may be printed and used to help educate people about our programs. To request alternate formats, please call (802) 241-0294.
Disabilities, Aging and Independent Living
CFC
Forms and Applications
Forms include program applications, documents and assessment tools used to administer each program managed by ASD
Adult Day Services Forms
CFC 706 Adult Family Care Referral Form
Tuesday, March 16, 2021
Room and Board Calculator 2021
Tuesday, December 22, 2020
Room and Board 2021
Tuesday, December 22, 2020
Adult Day Services
Tuesday, October 27, 2020
CFC 805D Adult Family Care Service Plan
Monday, July 12, 2021
Description:
Adult Family Care Service Plan
CFC 805A HB GDAC Service Plan
Friday, July 9, 2021
Description:
CFC 805A HB GDAC Service Plan
CFC ERC Start Date Process - August 2020
Wednesday, September 30, 2020
RCH-ALR Medicaid House
Tuesday, September 29, 2020
Pages
Contact Us
Angela Smith-Dieng, 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
This is a Division of the
Department of Disabilities, Aging and Independent Living
under the Agency of Human Services