Application for Intellectual and Developmental Disability (I/DD) Services Through the New Jersey Children's System of Care
Dear Parents and Caregivers:
Out of an abundance of caution, PerformCare recommends that eligibility applications for CSOC intellectual and developmental disability services be submitted online through the Family Portal.
Completing the application online will also process faster at this current time.
Please note that the Family Portal only supports Internet Explorer version 11 or greater. Download Internet Explorer on Microsoft’s website.
For youth determined eligible for Developmental Disability Services
Applications for eligibility for developmental disability services for children under age 18 must be submitted to PerformCare, the Contracted System Administrator for the New Jersey Children's System of Care (CSOC).
The application materials below may be downloaded and printed out for completion by hand. You may also call PerformCare at 1-877-652-7624 to request that the application materials be mailed to you. There is also an online application available:
Please note: If your child also has mental health needs or is in crisis, the eligibility application is not required to immediately access behavioral health services through CSOC. PerformCare is available to help you 24 hours a day, seven days a week, at 1-877-652-7624. For a life-threatening emergency, always dial 911.
You can also review a list of services currently available through CSOC.
Downloadable instructions and guidelines
Please review these forms and use them as a guide for submitting your application.
- Getting ready checklist (PDF)
- Citizenship and residency requirements (PDF)
- Timeframes for Clinical Assessments Submitted for Developmental Disability Eligibility Determination (PDF)
Application forms: required
- Form A: Applicant information and declaration (PDF)
- Form B: Child adaptive behavior summary (CABS) (PDF)
- Form C: Documentation checklist (PDF)
- Form D: privacy practices acknowledgement (PDF)
Forms A through D listed above are required, along with appropriate medical and other documentation as identified in the forms. Some applications may also need an Authorization for Disclosure of Health Information form (PDF). For more information on this form, please see the Authorization for Disclosure of Health Information section below or visit the PerformCare Forms page.
The completed application forms and supporting documentation should be mailed to PerformCare at the following address:
PerformCare New Jersey
Attention: DD Eligibility Unit
300 Horizon Drive, Suite 306
Robbinsville, NJ 08691
Authorization for Disclosure of Health Information
Some applications may need an Authorization for Disclosure of Health Information form. PerformCare may ask you to complete an authorization form in order to allow another person or organization of your choosing, such as a doctor or your child’s school, to communicate with PerformCare about your child’s needs in regards to the application. For more information on completing and mailing the authorization form, please see the Forms page.
You can also visit the main page for the I/DD eligibility application process to find out more information.