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How To Receive Respite - Application
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 Welcome to the Family Respite program!  

 

 

 

  

 

 

The following documents will help you apply to receive respite services. When submitting an application for respite services, be sure to include a copy of your child(ren)’s most recent comprehensive evaluation/assessment (less than a year old) and income verification- a copy of last year’s tax return or copies of letters of eligibility from the state.  For evaluations that are more than a year old, include a letter from your child’s clinician stating that treatment and behavior plans are in line with the evaluation. We’ve tried to keep these forms user-friendly but if you have any questions, please call us at 622-5767.

 

***If you currently have a respite worker (a friend, family member, etc.) that you would like to continue to work with, please encourage that person to contact us and begin their application process to become a NAMI Maine Respite Provider.

 

 

Let us introduce you to the Family Respite Program! Families qualify for 24 hours of respite per month and you choose who you want as a provider - a friend, relative or one of our fully qualified providers.

Complete Family Respite Application
This is basic information we need to know about how to contact you. Please be sure to include your email address! 
                          
You will need to complete a separate child application for each child that qualifies for respite services. We will also need a current evaluation/assessment to accompany the application. 

This form is required and helps us determine whether you qualify for for a co-pay. Please include a copy of last year's tax return, eligibility documents or bank statements with the form. 


 

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