Forms & Publications

Brochures [PDF]

Guide to Choosing a Nursing Home
Medicare & You 2012
Senior Medicare Patrol
The Gift of Peace of Mind Booklet

Printable Forms [PDF]

Basic Needs Assistance Program (Formerly SLP) Application
Living Will & Medical Power of Attorney Form
NAPIS Client Registration Form
Power of Attorney Form
Senior Outreach Counseling/Intake Form

Information Sheets [PDF]

Community Services Site Offices
Elderly Waiver Qualifications Benefits
FY12 IFCSP Guidelines
Independent & Assisted Living Housing list
Medicaid Eligibility for Home-Based or Nursing Home Expenses
Medicaid Program Desk Aid
Nursing Facilities Surrounding Polk County
Office of the State Long-Term Care Ombudsman
Polk County In-home Service Provider List
Polk County Transportation Services