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This document is a funding request form for mental health and developmental disability services in Poweshiek County. It is used to apply for county funding after determining eligibility through a
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How to fill out POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST

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Step 1: Obtain the POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST form from the official county website or local government office.
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Step 2: Read the eligibility criteria to ensure you qualify for funding.
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Step 3: Fill out your personal information at the top of the form, including your name, address, and contact information.
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Step 4: Provide detailed information regarding the services you are requesting funding for, including descriptions and costs.
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Step 5: Include any required documentation that supports your request, such as treatment plans or quotes.
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Step 6: Sign and date the form at the bottom to certify that the information is accurate.
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Step 7: Submit the completed form along with any attachments to the appropriate county office, either by mail or in person.
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Step 8: Keep a copy of the submitted form and any supporting documents for your records.

Who needs POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST?

01
Individuals with mental health or developmental disabilities residing in Poweshiek County who require financial assistance for services.
02
Families or guardians of individuals with mental health or developmental disabilities seeking funding for treatment or support.
03
Service providers in Poweshiek County wishing to support their clients through the funding request process.
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The POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST is a formal application process for agencies and organizations seeking funding to support mental health and developmental disabilities services within Poweshiek County.
Entities that provide mental health and developmental disabilities services in Poweshiek County, including non-profit organizations, governmental agencies, and other service providers, are required to file this request.
To fill out the POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST, applicants typically need to complete a designated application form, provide detailed information about their services, budget, and other relevant financial information, and submit it according to the guidelines set by Poweshiek County.
The purpose of the POWESHIEK COUNTY MH/DD SERVICES FUNDING REQUEST is to allocate financial resources to support and enhance the availability and quality of mental health and developmental disability services for residents of Poweshiek County.
The information that must be reported includes details about the services provided, the target population, funding needs, budget information, outcomes expected from the funding, and other supporting documentation as required by the county.
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