Is ACRC the right agency to help?

There are many conditions that may cause an individual to have impaired functioning in their daily lives, such as psychiatric disorders (for example ADHD, schizophrenia, mood disorders, anxiety), learning disabilities, language disorders, and/or medical conditions. It is important to understand that while applicants to regional center may have any of these other conditions, in order to be considered for regional center eligibility the applicant must be found to have at least one of the five conditions listed in the definition for developmental disability.

If an individual needs services and supports but is not suspected of having a developmental disability as described above, the regional center may not be the appropriate agency to meet the individual's needs and this application should NOT be completed. Please seek other resources.

In order to determine the applicant's eligibility, ACRC will complete the intake assessment which may include collection of historical diagnostic information, such as medical and school records, and prior psychological testing. The applicant's information is confidential and will not be released without your written consent. Included with this application, you will find a list of the types of records that are helpful to us. Your assistance in helping us obtain these records is greatly appreciated and may help speed up the Intake & Eligibility process. The Intake Unit will need to review this information as a necessary part of the intake and eligibility process.

List of Records and Reports to Obtain

Below is a list of the types of records that will help us understand why there is a concern for developmental disability for this applicant. If you do not already have these records that you can pass along to us, or cannot get them on your own in a timely manner, we will help gather them by sending out authorized requests for records. This list is not an exhaustive list, so if there are other types of records that you think might be helpful for ACRC to review and consider, please send them in or let us know where we can send for them.

Psychological Evaluations All reports that contain any psychological testing; usually completed by a psychologist or neuropsychologist (PhD, PsyD)
SSI Evaluations Any reports completed as part of the SSI application process
Developmental Consultations All records and evaluations by a developmental pediatrician (MD)
Individualized Educational Program (IEP) This includes goals and service plans. We need the latest IEP and all triennial reports (done every 3 years)
School Psychoeducational Evaluations All psychoeducational (triennial) reports by a school psychologist (MS, MA, EdD, PhD)
Speech Therapy Reports Reports by school and/or private practice speech pathologists (SLP)
Occupational Therapy Reports Reports by school and/or private practice occupational therapists (OT)
Physical Therapy Reports Reports by school and/or private practice physical therapists (PT)
Teacher Notes Notes, letters, emails, reports from school personnel that describe concerns and/or the daily functioning of the applicant
Medical Records Records that are RELATED TO THE SUSPECTED DEVELOPMENTAL DISABILITY and major medical issues (e.g. syndromes, genetics, etc.)
Neurology Records Information from neurology clinic
Psychiatry Records Records that include current and past psychiatric diagnoses
Psychiatric Hospitalization(s) Intake/Discharge records from any psychiatric hospitalization(s)
PM&R (Physical Medicine and Rehabilitation) Documentation on motor function, which helps us determine eligibility for Cerebral Palsy or Epilepsy. (May have been seen via insurance, MTU clinic or Shriners)
Birth Records May include diagnosis leading to eligibility determination or etiology for Cerebral Palsy or Epilepsy
Medical Genetics and Genomics Genetic laboratory results and consultation notes
Legal Guardianship of a Minor Need final Letters of Guardianship document from court
Adopted Minor Need either updated birth certificate or final adoption document from court
Conservatorship (of an Adult) Need final Letters of Conservatorship document from court