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DAIL Housing Accessibility Assessment Forms

DAIL Housing Pre-Inspection for Accessibility Assessment (Fillable Form) - The DAIL Housing Pre-Inspection for Accessibility Assessment form is used by the Providing Agencies in the pre-inspection of a home, prior to contacting the DAIL Contractor to schedule a Accessibility Assessment.
(Non-Fillable) DAIL Housing Pre-Inspection for Accessibility Assessment form

Agency Accessibility Modification Plan and Request for Modification Reimbursement (Fillable Form) - The Provider Agency is responsible for overseeing the implementation of a plan to initiate the home modifications and uploading the plan into the DAIL Housing Portal and overseeing the completion of the modification(s).
(Non-Fillable) Agency Accessibility Modification Plan and Request for Modification Reimbursement

Agency Accessibility Modification Plan and Request for Modification Reimbursement, Attachment - This is a supplemental form for Agency Accessibility Modification Plan And Request for Modification Reimbursement, when additional space for listing Assessment items is needed.
(Non-Fillable) Agency Accessibility Modification Plan and Request for Modification Reimbursement, Attachment

DAIL Housing Accessibility Modification Reimbursement Information and Notification process - Additional information and resources for requesting home modification reimbursement.