Thank you for applying for Easterseals respite voucher program. Please be sure you are completing the correct form. This application is for the Lifespan Respite program.
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If you are caring for a child under 18 with a behavioral or mental health issue, please complete the application for
Child and Adolescent Caregiver Respite.
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If you are a grandparent or other non-parent relative 60 or over caring for a child under 18, please complete the application for
Relative Respite.
All others, please continue with this application.
All information and comments in this application are confidential, however, the Lifespan Respite Program and the Caregiver Resource Center are both partially funded through the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD). Therefore, we are required to share information provided in this application with DSAAPD. Additionally, applications are shared with our application review commitee to determine eligibility and funding award.