Thank you for applying for an Easterseals respite voucher program. Please be sure you are completing the correct application. This form is for the Relative Respite program. To be eligible for the Relative Respite Program:
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you must be
60
years of age or older (new age this year)**
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the child or children for whom you provide care must be 17 years of age or younger
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you must have primary responsibilty for the care of the child or children
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you must be related to the child or children by blood, marriage, or adoption.
**Please note: if you previously qualified for the Relative Respite Program because you were 55 or over, you will still qualify.
All information and comments are confidential, however, the Relative 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, regardless of the age of the care recipient, we are required to share information provided in this application with DSAAPD.