Individual service plan examples 2025

1. Click ‘Get Form’ to open the individual service plan in the editor.
2. Begin by filling in the Waiver Program and Plan Type fields. Select the appropriate waiver from the options provided.
3. Enter the Medicaid ID Number, followed by the individual's full name, address, city, state, and zip code. Ensure accuracy for effective communication.
4. Complete the contact information section including telephone and email addresses. This is crucial for updates and notifications.
5. Document the Service Plan Development Date and Functional Screen Date to establish timelines for services.
6. Fill in financial details such as Cost Share Amount and Level of Care based on assessments provided.
7. For startup costs, specify any one-time expenses necessary for community living. This ensures all required resources are accounted for.
8. Review all entries for completeness before saving or sharing your document through our platform.

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