Polk County Oregon

Developmental Disabilities

Developmental Disabilities Request for Eligibility Determination

Polk County Mental Health provides the following document for your reference and convenience.

Supporting Documents

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DD Request for Eligibility Determination (English) (415 KB)

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DD Request for Eligibility Determination (Spanish) (453 KB)

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DD Request for Eligibility Determination (Russian) (472 KB)

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DD Request for Eligibility Determination (Vietnamese) (454 KB)

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DD Request for Eligibility Determination (Chinese) (409 KB)

DD Request for Eligibility Determination (Marshallese) (81 KB)