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Forms For Support Coordinators And Providers

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Forms, forms, and more forms. This state just loves paperwork. We hope to at least make life a little easier for you by providing links to all those commonly used forms.

 
Note Writing Assistance
QkNotes

At this time most support coordinators have access to note writing software. To obtain this software, call (727) 841-8943.

APD Forms- Support Coordination

Support Coordination Forms-  Support Plan, Waiver Eligibility, Information Sheet, Consent to Obtain/ Release Information, Central Record Transfer, Case Closure, Support Plan Extension, and Personal Outcome Notes.

Support Coordination Forms

Form # Document Name PDF Version  
CFOP 16013 Statewide Forms Used by Waiver Support Coordinators CFOP 16013  
APDF 03-001 Residential Placement Referral APDF 03-001  
APDF 04-001 Request for Annual Support Plan Extension APDF 04-001  
APDF 04-002 Support Plan/Support Plan Update APDF 04-002  
APDF 10-002 Central Record Transfer Form APDF 10-002  
APDF 10-003 Consent To Obtain or Release Confidential Information APDF 10-003  
APDF 10-004 Personal Outcome Notes APDF 10-004  
APDF 10-005 Client Information Sheet APDF 10-005  
APDF 10-006 Case Closure Form APDF 10-006  
APDF 10-008 Waiver Eligibility Work Sheet APDF 10-008  
Combined All Forms All Forms  
Document Link
Prior Service Authorization Request for Reconsideration - Form 4 PSA-Form 4
Amendment Request Form Amendment Request
Computer Programs, Just For Providers.
Need A Billing Agent?
Required Trainings
OSS Form

Alternate Care Certification Optional State Supplementation Form, know as the "OSS Form"

2515 Form

The DCF Certification of Enrollment Status HCBS Form, also known as the "2515 Form".

RFA Form

RFA Form/ Request For Assistance Form/ Access Florida Application

DCF Forms
Cost containment worksheet

Compare Group Home Costs VERSES Supported Living. This is the form you have to do before you request supported living for somebody.