Family Reimbursement Resources
Access all required forms and guidelines for the Family Reimbursement process. Download, review, and attach the needed documents for a complete application.
To be considered, please fill out the forms and submit your completed application with required documents to FamilySupport@elmysspecialservices.org
For more information or queries, please reach out to us at (929) 316-0957
Family Reimbursement Application
To apply for Family Reimbursement, all applicants must complete and submit this application. Families and/or Care Manager can complete the application but the caregiver must sign it.
Allowable and Non-Allowable Items
Please find a full list of items that are Allowable and Non-Allowable through Family Reimbursement.
General Reimbursement Guidelines
The document attached below highlights and lists general guidelines for applicants to be aware of for Family Reimbursement Support.
Family Attestation Letter
This document is to attest that the Family Reimbursement applicant lives at home with family. Please attach it to your application when submitting.
Respite Verification Form
If applicable, please download and fill out the attached Respite Verification form and attach it to your application.
Contact us
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Elmy's Special Services 501c (3) serving the special needs community since 2016.
