Forms

Registration Information

Participant Forms

Intake Forms

Anyone new to North East must schedule an intake meeting with one of our Recreation Therapists.
Please call our office, 914-347-4409 as soon as you can to make sure the desired programs still have availability. During
the intake meeting, you, your child, and our staff will work together to determine which programs will
be best suited and of interest to your child.
North East can no longer accept new registrants who are 21 years of age or older residing outside our
consortium region who are not approved by OPWDD for respite services.
For new Individuals who are enrolled with HCBS Medicaid Waiver and are 21 years & older: North East
will only accept those residing outside of our consortium region who are approved for respite services.
Individual may not start programs until all required documentation is properly submitted by Care
Manager or Parent. Documents include Service Authorization, Notice of Decision, Level of Care, and
Individual Service Plan. North East must be included in the person’s ISP. Individuals may not begin
programs until North East is notified the billing for reimbursement process is completed.

Special Olympics Forms