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Management Use Only: MANAGEMENT WILL PROVIDE HELP IN REVIEWING THIS DOCUMENT. IF NECESSARY, PERSONS WITH DISABILITIES MAY ASK FOR THIS APPLICATION IN LARGE PRINT TYPE, OR OTHER ALTERNATE FORMATS.450460
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01
Gather all necessary information about the person with disabilities such as their personal details, medical history, and any special needs or accommodations they may require.
02
Ensure that all information provided is accurate and up-to-date.
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Use a person-centered approach when filling out the form, focusing on the individual's strengths, abilities, and goals.
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Seek input from the person with disabilities themselves, as well as their caregivers and support network, to ensure that their needs and preferences are accurately reflected.
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Double-check the form for any errors or missing information before submitting it.

Who needs persons with disabilities may?

01
Employers who are looking to provide reasonable accommodations for employees with disabilities.
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Service providers who need to tailor their services to meet the specific needs of individuals with disabilities.
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Government agencies or organizations that require accurate information about persons with disabilities for planning and policy-making purposes.
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Persons with disabilities may be eligible for certain accommodations, rights, and benefits.
Individuals with disabilities or their legal guardians are required to file for persons with disabilities benefits.
To fill out persons with disabilities benefits, individuals need to provide information about their disability, medical history, and daily living needs.
The purpose of persons with disabilities benefits is to provide assistance and support to individuals with disabilities to help improve their quality of life.
Information about the individual's disability, medical history, and daily living needs must be reported on persons with disabilities benefits.
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