The process of obtaining essential supplies for individuals with developmental disabilities can be intricate, yet it is crucial for ensuring their well-being and dignity. The DDD-1426AFORPF form serves as a vital tool in this process, specifically designed by the Arizona Department of Economic Security's Division of Developmental Disabilities to help individuals aged 3-21 access necessary diaper and brief supplies. This form not only facilitates a streamlined request of diapers or briefs but also underscores the commitment of the department to cater to the health and hygiene needs of these individuals. It meticulously collects member information, including the individual's name, date of birth, AHCCCS ID number, and contact details, ensuring a personalized approach to each request. The attachment of a primary care provider's script, along with a disability diagnosis and a specified need date from the Individual Support Plan (ISP), emphasizes the form's comprehensive nature in addressing incontinence issues. The effort to accommodate a variety of sizes and types of diapers and briefs illustrates an understanding of the diverse needs within this age group. Additionally, the form serves as a reminder of the department's adherence to various civil rights acts and the Americans with Disabilities Act of 1990, ensuring that no individual is discriminated against and that reasonable accommodations are made for those with disabilities. Furthermore, the process for submission, whether through fax, mail, or interoffice delivery, highlights the form's accessibility to those seeking assistance.
| Question | Answer |
|---|---|
| Form Name | Form Ddd 1426Aforpf |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | 795M, DDD-1426AFORFF, ddd forms, 1975 |