cila application Preview on Page 1

Application for 60D CILA Support Services - dhs state il 2026

Here's how it works

  • 01. Edit your cila application online

    Type text, add images, blackout confidential details, add comments, highlights and more.

  • 02. Sign it in a few clicks

    Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

  • 03. Share your form with others

    Send form 60d via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Application for 60D CILA Support Services - dhs state il with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the Application for 60D CILA Support Services in the editor.
  2. Begin by filling out the 'Individual Information' section. Enter the individual's name, Social Security Number, Recipient Identification Number, date of birth, and gender. Ensure all details are accurate.
  3. Complete the 'CILA Provider & Site Information' section. Input the provider agency name, DHS number, address of the CILA site, and total residential capacity. Specify the level of support services provided.
  4. If applicable, answer questions regarding intermittent or family/relative support services in section 17. Provide details on direct support hours and any additional staff needed.
  5. Fill out the 'Rate Type / Resident Location Information' section by marking appropriate options based on the individual's circumstances prior to placement.
  6. Finally, ensure both CILA provider and ISC agency representatives sign and date the application. Attach all required documents as listed at the end of the form.

Start using our platform today to easily complete your application online for free!

See more cila application versions

We've got more versions of the cila application form. Select the right cila application version from the list and start editing it straight away!

VersionsForm popularityFillable & printable
20143.9 Satisfied (29 Votes)

be ready to get more

Complete this form in 5 minutes or less

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Apply for Benefits Download the application. IL444-2378 B - Request for Cash Assistance, Medical Assistance, Supplemental Nutrition Assistance Program (SNAP)(IES)(pdf) Follow the directions on the form. Once youve completed the application, carry, mail or fax it to your local Family Community Resource Center.
Apply Using the Phone Please call our toll-free line ABE Help Line at 1-800-843-6154 (Voice), Nextalk 1-800-324-5553, 711 TTY Relay, if you have questions or need help with the application.
You may be eligible for General Assistance if you are unemployed and actively seeking employment or are currently awaiting a decision on a Social Security disability claim. All General Assistance applications are strictly confidential.
How Do I Apply? In Person. Apply in person at an Illinois Department of Human Services Family Community Resource Center. By Phone. Apply by phone by calling 800-843-6154. Online. Apply online at the Illinois Application for Benefits Eligibility (ABE).
Obtain a Community Integrated Living Arrangement (CILA) license issued by the Bureau of Accreditation, Licensure and Certification. Apply for a National Provider Identification Number (NPI) on the National Plan and Provider Enumeration System website. The NPI must be a Type 2 - Organizational NPI number.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

People also ask

Program Options Help to Buy Food. Meet your familys nutritional needs. Healthcare. Support for your familys medical needs. Cash Assistance. Other aid for families in need. Community Supports. Help for adults with long term needs. Medicare Savings. Help paying Medicare premiums.

application cila

DHS: Rehabilitation Services: Apply Online - Illinois.gov

To apply for services, begin by completing the form below. Once you have submitted this form, a counselor will contact you to set up an appointment.Read more

Learn more
If you believe that this page should be taken down, please follow our DMCA take down process here