Select the appropriate form below to apply for our community-based care programs

Fill and submit the form below with correct information, an email will be sent to you promptly.

EDWP Intake Form

Elderly and Disabled Waiver Program

This form is for individuals seeking assistance through the Elderly and Disabled Waiver Program. Please complete all required fields to begin the application process for home and community-based services.

Fill EDWP Form

GAPP Intake Form

Georgia Pediatric Program

This form is for parents and guardians applying for the Georgia Pediatric Program. Provide accurate information about the child’s needs to help us determine eligibility for specialized care services.

Fill GAPP Form