Get Md Developmental Disabilities Administration (dda) Low Intensity Support Services (liss) Program 2022-2025

Filling out the MD Developmental Disabilities Administration (DDA) Low Intensity Support Services (LISS) Program application online can be a straightforward process when guided correctly. This guide provides a comprehensive overview of each section and field, helping ensure that you provide the necessary information accurately.

Follow these steps to complete your application effectively.

1. Click the ‘Get Form’ button to obtain the application form and open it in the designated editor.
2. Begin by completing the applicant information section. This includes the first name, middle name, last name, mailing address, social security number, date of birth, and telephone number of the individual with a developmental or intellectual disability.
3. Proceed to the service information section. Here, specify the service or item requested. Ensure that this is clearly stated as it is essential for processing your application.
4. Provide the name and address of the vendor or service provider you are requesting support from. Accuracy here is crucial to prevent processing delays.
5. If applicable, include the licensed professional's name and their license number. This step is particularly important if you are utilizing licensed service providers.
6. Input the telephone number of the vendor or service provider for direct communication regarding your request.
7. Indicate the total amount requested for the service or item specified earlier.
8. Specify the date(s) of service, making sure they fall within the current fiscal year, to comply with program requirements.
9. Provide the daily or hourly rate and the corresponding amount of days or hours needed. This clarity assists in budget assessments.
10. In the reason section, explain why you are requesting the specified service or item. Be thorough and clear to support your application.
11. Review all provided information for accuracy. It is essential that the information is complete and correct before proceeding.
12. When you are satisfied with the completed application, you may save your changes, download a copy, print it for your records, or share it with relevant parties.

Begin your application now and ensure that you complete the MD DDA Low Intensity Support Services application online with ease.