• Who is eligible?
• Who Should Apply?
• Application form

WHO IS ELIGIBLE?

Eligibility is based on definitions found in Maryland State law. Health-General Article, Title 7, Developmental Disabilities Law. Services are not an entitlement. Individuals must be Maryland residents to apply and be determined eligible for DDA services. Two groups of individuals are eligible for services.

1. Those with developmental disabilities and;
2. Those who have a severe, chronic disability which is caused by a physical or mental condition, other than a sole diagnosis of mental illness.

An individual is considered to have a developmental disability if she/he has a physical or mental condition other than a sole diagnosis of mental illness and needs to have services which are individually planned and coordinated. The condition has to be likely to continue indefinitely and has to be manifested before the age of 22, with the result of the condition being an inability to live independently.

An individual who does not meet the definition of developmentally disabled may be eligible for Individual Support Services. One must have a severe, chronic disability, which is caused by a physical or mental condition other than a sole diagnosis of mental illness, and the condition has to be likely to continue indefinitely.

An individual's eligibility for services provided by any other public or private agency is not affected by the individual's eligibility for DDA services.

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WHO SHOULD APPLY FOR SERVICES?

Anyone with a severe, chronic disability who needs residential, day or support services may apply. The application for service may be completed by the person with the disability, by someone who provides care, or by any other interested person.

Application Form

You may print our

• eligibility/application for service form (English)
• eligibility/application for service form (Spanish)

Complete and return to:

DDA - WESTERN REGIONAL OFFICE
1360 MARSHALL STREET
HAGERSTOWN, MARYLAND 21740

We also have available fill-in-forms that you can download and complete on your computer.

Fill-in forms allow you to enter information while the form is displayed by an Adobe Acrobat 3.0 (or later) product and then print the completed form out or save it. Fill-in forms give you a cleaner crispier printout for your records and the ability to email your completed form to us.

Please review the fill-in-form instructions for software requirements and detailed instructions on the usage.

If you have questions call: 301-791-4670; toll free 1-888-791-0193

The freely available Adobe Acrobat reader is required to view and print PDF files.

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Fill-in Forms Instructions

Overview

Fill-in forms use the features provided with Acrobat 3.0 products. Currently, there is no computation, validation or verification of the information you enter and you are still responsible for entering all required information.

Software Requirements

To view, complete and print fill-in forms you'll need the freely available Acrobat 3.0 Reader (or later) software installed on your computer. Acrobat Reader does not allow you to save your completed forms to disk. The ability to save completed forms is available commercially with the Adobe Acrobat 3.0 (or later) product suite.

Completing the Form

• To download the form your web browser may be configured with an Acrobat plug-in to automatically open the file within your browsers window upon download. To save the file directly to disk right click on the link then select "Save Target/Link As.." when presented with a menu.
• Use Acrobat 3.0 to open the file if necessary.
• Select the hand tool from the Acrobat toolbar menu. You can use the hand tool to move the page around so that you can view all the areas on it.
• Position the hand pointer inside a form field and click. The I-beam pointer allows you to type text. The arrow pointer allows you to select a check box, a radio button, or an item from a list.
• Use your mouse to select an area of the form that is not inside a form field before printing your form. If a form field is active (contains the blinking bar) the contents will not print. You may also use the save tab to save your form.
• If the fill-in form is displayed within your web browsers window be sure to use the printer button on the Acrobat toolbar menu to print the form instead of your web browsers print function.

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