Application for Intellectual and Developmental Disability (I/DD) Services Through the New Jersey Children’s System of Care
Applications for eligibility for developmental disability services for children under age 18 must be submitted to PerformCare, the Contracted System Administrator for the New Jersey Children's System of Care (CSOC).
The application materials below may be downloaded and printed out for completion by hand. You may also call PerformCare at 1-877-652-7624 to request that the application materials be mailed to you. There is also an online application available.
Please note: If your child also has mental health needs or is in crisis, the eligibility application is not required to immediately access behavioral health services through CSOC. PerformCare is available to help you 24 hours a day, seven days a week, at 1-877-652-7624. For a life-threatening emergency, always dial 911.
You can also review a list of services currently available through CSOC.
Downloadable instructions and guidelines
Please review these forms and use them as a guide for submitting your application.
- Getting Ready Checklist (PDF)
- Citizenship and Residency Requirements (PDF)
- Timeframes for Clinical Assessments Submitted for Developmental Disability Eligibility Determination (PDF)
Application forms: required
- Form A: Applicant Information and Declaration (PDF)
- Form B: Child Adaptive Behavior Summary (CABS) (PDF)
- Form C: Documentation Cover Sheet (PDF)
- Form D: Notice of HIPAA Privacy Practices Acknowledgement (PDF)
Forms A through D listed above are required, along with appropriate medical and other documentation as identified in the forms. The completed application forms and supporting documentation should be mailed to PerformCare at the following address:
PerformCare New Jersey
Attention: DD Eligibility Unit
300 Horizon Drive, Suite 306
Robbinsville, NJ 08691
For those who prefer, this application is also available to complete online, with real-time tracking of your application status.
Please review all the forms and materials above before completing the application online.
You can also visit the main page for the I/DD eligibility application process to find out more information.