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DIVISION OF SERVICES FOR PEOPLE WITH DISABILITIES Utah DISUSED 1/00 1 Page1 of DIRECT FINANCIAL ASSISTANCE LOG Form 28L Name of Person / Family with whom we have agreement Month or Quarter : 1st 2nd
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Who Needs Utah DHS-DSPD Division of?

01
Individuals with disabilities who require support services to enhance their quality of life.
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Parents or legal guardians of children with special needs who need assistance in accessing resources and support.
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Caregivers or relatives who are responsible for the well-being and care of a person with disabilities.
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Service providers or professionals working with individuals with disabilities who may require the involvement of the Utah DHS-DSPD Division to provide necessary services and support.
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The Utah DHS-DSPD division is responsible for overseeing services for individuals with disabilities.
Providers and facilities serving individuals with disabilities are required to file with the Utah DHS-DSPD division.
To fill out the Utah DHS-DSPD division form, providers need to report specific information about the services they offer to individuals with disabilities.
The purpose of the Utah DHS-DSPD division form is to ensure that individuals with disabilities receive the necessary services and supports.
Providers must report on the types of services they offer, the number of individuals served, and outcomes achieved.
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Utah 3rd 4th WPD 2nd DFALOG 2-8L dhs dspd Page1 1st DISABILITIES

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