Department of Aging

State of Pennsylvania

Official Website: https://www.aging.pa.gov/

​The mission of the Pennsylvania Department of Aging is to promote independence, purpose, and well-being in the lives of older adults through advocacy, service, and protection.
The Pennsylvania Department of Aging works to ensure that older adults across Pennsylvania have access to quality services and supports that help them age and live well.

Forms & Documents

Browse all Department of Aging government forms

1 - 20 of 54 forms

Form Title Topics
19-04-01 Health and Wellness Annual Plan Format_Title IIID
Adult Day Center Intake Screening
AGING TECHNICAL ASSISTANCE BULLETIN
APD 03-25-01 Revised Domiciliary Care Agreement Forms
APD 03-25-01 Revised Domiciliary Care Agreement Forms Attachment
APD 03-25-01 Revised Domiciliary Care Agreement Forms Attachment 2
APD 07-05-01 Elig Determination IEP Forms
APD 09-01-01 Interim Incident Management Procedures for Aging Waiver
APD 15-01-09 -Chapter IX - Assessment
APD 15-24-01 RON Intake and Payment for Ages 18-59
APD 19-29-01 Department of Military and Veterans Affairs Veterans Registry Enrollment and Reporting
APD 95-01-09 Assessments
APD 97-24-01 Protective Service Report of Need
Appendix C.2 - CSP Self-Employed-Independent Contractor Declaration Form
Appendix C.3 - Caregiver Reimbursement for Services and Supplies Form
Appendix C.4 - Caregiver Reimbursement for Personal Care and In-Home Respite Services Form
Appendix E.5. Mandatory Abuse Reporting Packet 2019
Appendix G.2. OAG Referral Form - 2021-03-03
Appx C.3 OPTIONS Consumer Reimbursement Form_Other
Caregiver Assessment Tool Form

Contact Information & Office Locations

1 contact point

Address:
555 Walnut St
5th Floor
Harrisburg, PA 17101

Phone numbers:
  • (717) 783-1550

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