Please complete the following application for Summer Recreation for the 2024 Summer season.
Before you begin, please be sure to have the following information ready:
- Emergency contact information
- Medicaid number and Tabs number
- Other Insurance information (if applicable)
- Diagnosis, allergies and medications
- Care Manager contact information
- Self Direction Support Broker and Fiscal Intermediary contact information (if applicable)
- Participants interests and fears
- Participants medical or dietary precautions, and adaptive equipment needs (including for transportation)
- OPWDD Eligibility Letter (to upload)
- Last two Life Plans (to upload)
- Current Level of Care (to upload)
- Service Authorization (if applicable) (to upload)
- Self- Direction Budget (if applicable) (to upload)
If you have any questions, please contact communitysupports@aimservicesinc.org