• New Hope Application for Services

    Applicant Information
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  • Eligibility Information

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  • Data Collection Notification

    The information we are requesting is essential for the proper management of the service you are applying for. If New Hope discovers that any information has been falsified or omitted, we reserve the right to deny services or, if you are currently receiving services, to consider discharge. Authorized personnel will only use the information collected for the purposes outlined here. Any other use of this information will not occur without your prior written consent, unless required by law. You also have the right to review the information this agency maintains about you.
  • Additional Material to Submit with this Application

    Social Hisotry, Psychological Report or Assessment, Incident Report, SIS Assessment/Inter RAI, Guardian/Conservatorship Papers, Physcial Exam, Service/Behavir Plans, Medication List & Diagnosis, and any other pertinent information.
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  • General Admission Criteria

    Must not have a felony conviction or be listed on the Sex Offender Registry· Must not require continuous 1:1 supervision· Must be able to regularly participate in daily activities and show progress or maintain skills · May require assistance but should be capable of learning and maintaining skills in mobility, self-help, communication, and leisure activities · If there is a history of seizure activity, it must be under moderate control · Must not have severe emotional, psychological, or behavioral issues. Severe aggressive, violent, or destructive behaviors, or behaviors that are criminal in nature, are not acceptable. Behaviors should not pose harm to the individual or others. Individuals requiring intensive use of restraints, time-out, or aversive techniques are not appropriate. Must not need intensive services for behaviors related to a psychiatric condition. New Hope will assess the behavioral and psychological needs of each individual to determine whether our services can effectively support those needs.
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