Para ver esta página en español
Please print the form, fill it out, and mail it to your local office.
CSHCN Services Program Application (708 KB, PDF) Publication #T-3
CSHCN Services Program Application in Spanish (744 KB, PDF)
The CSHCN Services Program Client Handbook, Publication #E07-12357 (575 KB, PDF), provides basic information for program clients.
Address Change Form
Address Change Form (483 KB PDF) / Formulario de cambio de domicilio Publication #EF07-12595, bilingual English and Spanish
Drug Co-Pay Reimbursement
Client Drug Co-Pay Reimbursement Request Form 2009 (47 KB Word) Publication #EF-07-13429, bilingual English and Spanish
Client Drug Co-Pay Reimbursement Request Form 2009 (96 KB PDF) Publication #EF-07-13429, bilingual English and Spanish
Physician/Dentist Assessment Form
CSHCN Services Physician/Dentist Assessment Form (118 KB PDF)
CSHCN Services Physician/Dentist Assessment Form Instructions (23 KB PDF)
School Attendance Verification Form
School Attendance Verification Form (482 KB PDF) Publication #EF-07-12840, bilingual English and Spanish
Emergency Forms and Information
Medication Form Publication #EF07-12780, bilingual English and Spanish (PDF)
Emergency Information Form Publication #EF07-12540, bilingual English and Spanish (PDF)
Emergency and Disaster Planning Guide Publication #4-2, bilingual English and Spanish (PDF)
The CSHCN Services Program Newsletter for Families is published quarterly.
Download the brochure in English Stock No. 4-1 (474 KB, PDF). The file contains a copy of the brochure in color and black and white. Use the bookmarks to access either the color or black and white version.
Summer Camps is a list of camps for children and others with special needs.
Send comments or report broken links by e-mail to CSHCN Services Program.