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SUPPORT BROKERAPPLICATION Submit completed application to: Idaho Department of Health and WelfareRegional Medicaid Services Bureau of Developmental Disability Services Attn: Cheryl Willard 3402 Franklin
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Support brokerapplication is a form used to request and facilitate support services for individuals with disabilities.
Parents or guardians of individuals with disabilities who require support services are required to file support brokerapplication.
Support brokerapplication can be filled out by providing detailed information about the individual with disabilities, their support needs, and contact information of the parent or guardian.
The purpose of support brokerapplication is to ensure individuals with disabilities receive the necessary support services to lead a fulfilling life.
Information such as the individual's medical history, support needs, educational goals, and contact information must be reported on support brokerapplication.
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