DADS Provider Communications

DADS Provider Alert Viewer

Forms updates

Form 8578 (Intellectual Disability/Related Condition Assessment), which as previously titled "Mental Retardation/Related Condition Assessment," has been updated to include respectful language. Additional minor changes were made including:

  • Elimination of references to the Consolidated Waiver Program (CWP)
  • Revision to Item #72 (for ICF only), which allows for an APN or PA to attest that the physician whose license is noted in Item #55 delegated Items 19 and 48-51 to the APN or PA
  • Revisions to the form’s instructions

Please begin using this revised version of Form 8578.  Entities with existing stock of hard copies of the previous version of Form 8578 have until June 1, 2012, to begin using the revised version.

Additionally, Form 8662 (Related Conditions Eligibility Screen Instrument) and its instructions have been updated to include respectful language.

Posted: 2/16/2012

Previous Page

Sign up for e-mail updatesIf you want to subscribe to this page, click here. DADS contracts with a company called GovDelivery,Inc., to provide e-mail updates. When you sign up for e-mail updates, you are giving your information to both DADS and to GovDelivery. When DADS has your information, it is subject to the DADS privacypolicy. When GovDelivery has your information, it is subject to their privacypolicy. Read the GovDelivery privacy policy.

top of page