Form F-00367 Functional Eligibility Screen for Children's Long-Term Support Programs - Wisconsin

Form F-00367 Functional Eligibility Screen for Children's Long-Term Support Programs - Wisconsin

What Is Form F-00367?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-00367?
A: Form F-00367 is the Functional Eligibility Screen for Children's Long-Term Support Programs in Wisconsin.

Q: What is the purpose of Form F-00367?
A: The purpose of Form F-00367 is to determine if a child is eligible for long-term support programs in Wisconsin.

Q: Who is eligible to fill out Form F-00367?
A: Parents or legal guardians of children under the age of 21 who have or may have a developmental disability may fill out Form F-00367.

Q: What information is required on Form F-00367?
A: Form F-00367 requires information about the child's developmental disability, functional limitations, and the need for long-term support services.

Q: How should Form F-00367 be submitted?
A: Completed Form F-00367 should be submitted to the county or tribe's children's long-term support agency.

Q: What happens after Form F-00367 is submitted?
A: After Form F-00367 is submitted, the child's eligibility for long-term support programs will be determined based on the information provided.

Q: Are there any fees associated with Form F-00367?
A: There are no fees associated with completing and submitting Form F-00367.

Q: Who can I contact for more information about Form F-00367?
A: For more information about Form F-00367, you can contact the county or tribe's children's long-term support agency in Wisconsin.

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Form Details:

  • Released on December 1, 2021;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form F-00367 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-00367 Functional Eligibility Screen for Children's Long-Term Support Programs - Wisconsin

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