DODD Workgroup Survey

Individual Service Plan

Early Intervention

Waiting List

Waiver Services

Adult Day Services

Employment

Intermediate Care Facility/Residential

Transportation

Nursing/Delegation

Provider Compliance

Provider Certification

Professional Development and Training for DSPs

County Board Compliance

Service and Support Administrators

Health and Safety, MUIs

Assessments (Ohio Developmental Disabilities Profile (ODDP), Acuity Assessment Instrument (AAI), Waiting List)

Eligibility

Other (please specify)

Morning 8-10 AM

Morning 10-12 AM

Afternoon 12-2 PM

Afternoon 2-4 PM

Evening 4-6 PM

Evening 6-8 PM

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number