Get Opwdd Universal Application

The Opwdd Universal Application is an essential document for accessing funding for family reimbursement services. This guide provides clear, step-by-step instructions to assist users in filling out the application online, ensuring a smooth and efficient process.

Follow the steps to complete the Opwdd Universal Application online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the personal data of the person with a disability in Section 1. Fill in their full name, date of birth, address details, and contact information. Be sure to list the name of the parent or relative and indicate the total number of people living in the household.
3. In Section 2, answer whether you have sought funding from primary medical insurance or other resources. Mark ‘Yes’ or ‘No’ and provide the outcome of these efforts.
4. Section 3 requires you to list all reimbursement amounts received during the current calendar year. If necessary, add additional pages to document multiple entries, including the agency names, dates of service, and the amounts received.
5. In Section 4, specify the items or services for which reimbursement is requested. Include the total amount requested, the date of service, and the specific costs associated with the item or service.
6. For Section 5, list any other reimbursement agencies you have applied to regarding this request, including the dates and results for each agency.
7. Fill out Section 6 with the details of the service coordinator or social worker, including their name, agency, email, phone number, and fax number.
8. Complete Section 7 by checking off all required documents you are attaching to the application. This may include original receipts, letters from professionals, and any OPWDD eligibility documentation.
9. In Section 8, explain how the requested reimbursement directly relates to the individual's disability. Be specific and provide justifications as needed.
10. After thoroughly reviewing the completed form, you can then save your changes, download, print, or share the document as needed. Ensure that any required signatures are obtained before submission.

Start filling out your Opwdd Universal Application online today to ensure your requests are processed efficiently.