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Get the free In-Home Support Services (IHSS) Client Referral Form

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Income Support Services (IHSS) Client Referral Form To make a referral, complete and submit this form to the IHSS Agency of the clients choice. www.colorado.gov/hcpf/inhomesupportservicesReferral
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How to fill out in-home support services ihss

01
To fill out In-Home Support Services (IHSS), follow these steps:
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Collect necessary documents such as your social security card, proof of income, and proof of living arrangements.
03
Contact your local IHSS office to schedule an appointment or request an application form.
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Attend the scheduled appointment or complete the application form.
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Provide accurate and complete information about your needs and living situation.
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Submit the application along with the required documents.
07
Wait for the IHSS office to review your application and make a determination.
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If approved, a social worker will assess your needs and determine the number of hours you are eligible for.
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Once approved and assigned an IHSS worker, you can start receiving in-home support services.

Who needs in-home support services ihss?

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In-Home Support Services (IHSS) is primarily designed for individuals who have disabilities, are elderly, or have chronic medical conditions.
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The following individuals may benefit from IHSS:
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- Elderly individuals who need assistance with daily living activities, such as bathing, dressing, and meal preparation.
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- Individuals with physical or intellectual disabilities who require help with personal care and household tasks.
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- Individuals with chronic medical conditions who need assistance in managing their health and medications at home.
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IHSS is intended to support those who have difficulty performing daily tasks independently and would prefer to receive care in their own homes.
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In-home Supportive Services (IHSS) is a program that provides assistance with daily activities to individuals with disabilities or elderly individuals who need support to remain safely in their home.
Individuals with disabilities or elderly individuals who need assistance with daily activities in order to remain safely in their home are required to file for In-Home Supportive Services (IHSS).
To fill out the IHSS application, individuals can contact their local county social services office or visit the official IHSS website for guidelines and instructions on how to apply.
The purpose of IHSS is to help individuals with disabilities and elderly individuals remain safely in their homes by providing assistance with daily activities such as personal care, meal preparation, and household chores.
Information such as the individual's name, address, medical condition, current living situation, and need for assistance with daily activities must be reported on the IHSS application.
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