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Enter District Name Here Functional Mental Disability (FMD) Eligibility Determination Form Attachment to Admissions and Release Committee (ARC) Conference SummaryInitial Determination of Eligibility
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Functional Mental Disability (FMD) is a condition that impairs an individual's ability to perform daily tasks or interact with others.
Individuals with a diagnosed functional mental disability are required to file for FMD.
To fill out FMD, individuals must provide information about their condition, how it affects their daily life, and any relevant medical documentation.
The purpose of FMD is to inform healthcare providers and caregivers about an individual's condition and needs.
Information such as diagnosis, symptoms, treatment plan, and contact information for healthcare providers must be reported on FMD.
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