Intermediate Care Facilities For Persons with Intellectual Disabilities Application Package
The application package for Intermediate Care Facilities for Persons with Intellectual Disabilities must include all documents listed in the chart below. The Intermediate Care Facilities staff review each application package and determines an applicant’s eligibility for a license. Please follow the instructions for the Printable Forms and include all forms in the application package in hard copy format.
Printable Forms: Print the form, fill it out, and include it with the application package. Specific instructions are provided within each form below.