Children's Behavioral Health

Forms and Instructions

For Family  and Children

• 32 Children's Home and Community Waiver
  • Application (Word)
    •  Instructions (Word)
• Child or Adolescent Grievance
  • Form (This guide includes the instructions and the form to file a grievance) (Word* | also in PDF*)
• RCS 28
  • MaineCare, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations
• 65 HCT (Children’s Home and Community Treatment Services) Referral Form (Updated for October 01, 2010)
  • HCT Referral Process
  • 65 HCT Referral Form (Word*)
    • Instructions (Word* | also in PDF*)
• Individual Planning Funding
  • Form (This service is not an entitlement and is subject to availability of funds) (Word*)
  • Instructions (Word* | also in PDF*)