Applications for Intellectual and Developmental Disability (I/DD) Services Through the New Jersey Children's System of Care
Applications for Intellectual/Developmental Disability eligibility 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.
Applications are available in Spanish, Portuguese, Mandarin Chinese, Korean, and Gujarati.
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.
PerformCare reduces language barriers to accessing services through the New Jersey Children’s System of Care by providing language services at no cost to people whose primary language is not English, such as qualified interpreter services and information written in other languages.
If you need these services, contact PerformCare at 1-877-652-7624 or [TTY (for the hearing impaired) 1-866-896-6975]. We are available 24 hours a day, 7 days a week.
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Downloadable instructions and guidelines
Please review these forms and use them as a guide for submitting your application.
- Getting ready checklist (English) (PDF)
- Citizenship and residency requirements (English) (PDF)
- Timeframes for Clinical Assessments Submitted for Developmental Disability Eligibility Determination (English) (PDF)
Application form: required
- Application for Determination of Eligibility for Children Under Age 18 with Developmental Disabilities (Spanish) (PDF)
- Application for Determination of Eligibility for Children Under Age 18 with Developmental Disabilities (Portuguese) (PDF)
- Application for Determination of Eligibility for Children Under Age 18 with Developmental Disabilities (Mandarin) (PDF)
- Application for Determination of Eligibility for Children Under Age 18 with Developmental Disabilities (Korean) (PDF)
- Application for Determination of Eligibility for Children Under Age 18 with Developmental Disabilities (Gujarati) (PDF)
The application is required along with appropriate medical and other documentation as identified in the form. Some applications may also need an Authorization for Sharing Health Information form (PDF). For more information on this form, please see the Authorization for Disclosure of Health Information section below or visit the PerformCare Forms page.
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