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Division of Senior and Disabilities Services

Approved SDS Forms

Please Note: SDS is continuously making improvements to its many program forms so please check back frequently to ensure the most current version is utilized. You can refer to the “Revision Date” printed on the bottom left margin of each form to determine appropriate precedence. Specific programmatic questions about a particular form should  be addressed to the associated SDS program staff. Forms are posted as Microsoft Word and PDF user friendly documents that can be downloaded, saved and filled out for printing or electronic submission. Contact the DHSS webmaster if problems are encountered accessing forms as posted.

As of May 13, 2020, all SDS Approved Forms except for those noted with asterisks * are now fillable PDFs that are in compliance with Section 508 of the Rehabilitation Act of 1973.

Please note, the forms with an asterisk * need to remain interactive in Word or Excel so do not meet section 508 information and communication technology (ICT) compliance standards. For assistance with reading or completing any of these forms, please contact the Policy Unit at HSS.DSDS.Policy@alaska.gov.

COVID-19 Forms

Community First Choice Forms

Universal Program Forms

IDD Waiver Program Forms

ALI/APDD/CCMC Waiver Program Forms

Environmental Modification Forms for All Waivers

Adult Protective Services Forms

General Relief Forms

PCA Participant Application and Service Request Forms

Provider Certification Forms 

Material Improvement

Telehealth

Long Term Care Forms

TABI Forms

COVID-19 Forms

Universal Program Forms

ISW/IDD Waiver Program Forms

ALI/APDD/CCMC Waiver Program Forms

Environmental Modification Forms for All Waivers
As of February 21, 2020 the Envionmental Modification Forms are in compliance with Section 508 of the Rehabilitation Act of 1973.

Adult Protective Services Forms

General Relief Forms
As of February 24, 2020, the APS Forms and the General Relief Forms are in compliance with Section 508 of the Rehabilitation Act of 1973.

PCA Participant Application and Service Request Forms

Community First Choice Forms

Provider Certification Forms

Provider Certification Misc. Forms

    Material Improvement

    Teleassessment

    Long Term Care Forms

    TABI Forms

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     Updated 8/7/2020


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