DMAS-95, Level I Screening for Mental Illness, Intellectual Disability, or Related Conditions Form (rev. 4/2019)
DMAS-95, MI/ID/RC Supplement: Level II (rev. 12/2015)
DMAS-96, Medicaid-Funded Long-Term Services and Supports (LTSS) Authorization Form (rev. 4/2019)
DMAS-97, Individual Choice - Home and Community-Based Services or Institutional Care Form (rev. 4/2019)
DMAS-108, Private Duty Nursing Adult Referral for the Commonwealth Coordinated Care Plus (CCC Plus) Waiver (rev. 4/2019)
DMAS-109, Private Duty Nursing Pediatric Referral for the Commonwealth Coordinated Care Plus (CCC Plus) Waiver (rev. 4/2019)
Virginia Individual Developmental Disabilities Eligibility Survey - Infants' Version, P235 (eff. 3/2016)
Virginia Individual Developmental Disabilities Eligibility Survey - Children's Version, P236 (eff. 3/2016)
Virginia Individual Developmental Disabilities Eligibility Survey - Adults' Version, P237 (eff. 3/2016)
Virginia Uniform Assessment Instrument (rev. 5/2000)
Va. Admin. Code tit. 12, agency 30, ch. 60, form FORMS (12VAC30-60)
Amended, Virginia Register Volume 34, Issue 24, eff. 8/22/2018; Amended, Virginia Register Volume 35, Issue 09, eff. 2/7/2019; Amended, Virginia Register Volume 38, Issue 12, eff. 2/16/2022; Amended, Virginia Register Volume 41, Issue 01, eff. 10/10/2024.Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.