Developmental Services (DS)

• Programs/Services
• Policy/Rules
• Offices/Divisions

Information on

• Forms
• Resource Directory Forms
• Staff/Provider Training

Social Services Help

Developmental Services - Behavioral Regulations/Three Person Committee

Three Person Committee Forms

• Safety Device Approval Forms
  • approval of the use of safety/protective device procedure (Microsoft Word*) (Adobe PDF*)
  • approval of the use of safety/protective device (s)  (Microsoft Word*)
  • protective device authorization   (Microsoft Word*)
• Sample A
  • application for approval of severly intrusive intervention (Microsoft Word*)
  • consent/authorization (Microsoft Word*)
• Sample B
  • application for approval of severly intrusive intervention (Microsoft Word*)

---

For a free viewer or to request a hard copy

Maine.gov | DHHS Home | Site Policies | Language Access | Comments/Questions