Referral – angelcommunityalliance.com

Whether you’re a family looking for Early Intervention support, or an individual, caregiver, Service Coordinator, or discharge planner exploring NHTD or TBI Medicaid Waiver services, ACA is here to help. Complete the appropriate form below and a member of our team will reach out to discuss next steps.

Early Intervention Referral Form (Birth to Age 3)

Concerned about a child’s development? ACA can assist families with connecting to the Early Intervention Program and navigating the referral and Service Coordination process.

NHTD / TBI Medicaid Waiver Referral Form

Looking for NHTD or TBI Waiver services? ACA assists individuals, families, caregivers, Service Coordinators, discharge planners, and community partners with connecting to available NHTD and TBI Medicaid Waiver services.