Care Services

The client must complete and sign a DHS Adult Services Application form to receive home help services. An authorized representative or another person acting for the client may sign the form if the client is either:

• Incapacitated
• Has a court-appointed guardian

A client unable to write may sign with an X, witnessed by one other person (for example, a relative or department staff).

  << Adult Services Application>> 

The Medical Needs form must be signed and dated by a medical professional certifying a medical need for personal care services. 

The medical professional must be an enrolled Medicaid provider and hold one of the following professional licenses:

• Physician (MD or DO)
• Physician Assistant
• Nurse Practitioner

• Occupational Therapist

• Physical Therapist

<< Medical Need Form >>