If you are compensated for providing care, please select ID/A Direct Support.

Please use this selection if you are employed as a caregiver for at least one individual with ID/A. This includes family members who are compensated for providing direct care.

Please use this selection if you are employed as a program manager OR program specialist at an agency within the ID/A service system.

Please use this selection if you are employed in a clinical/medical position at an agency within the ID/A service system, including medical coordinator, nurse, CNA, etc.

Please use this selection only if you are an executive director for an agency within the ID/A service system.

Please use this selection you are a behavioral/mental health professional, whether employed at a provider agency within the ID/A system or a community organization.

Please use this selection only if employed at a designated Personal Care Home; if you are employed by a provider agency within the ID/A system, please select the applicable ID/A category instead.

If you are a MH case manager, please select ‘other’ and enter ‘MH Case Manager’ in the text box that appears.

Use this selection only if you are employed directly by the administrative entity, not by a separate agency.

 Use this selection only if you are employed directly by the Office of Developmental Programs, not by a separate agency.

Please use this selection if you are employed in a clinical/medical position at an organization NOT within the ID/A service system, including physician, nurse, medical assistance, Physical Therapist, Occupational Therapist, Speech/Language Therapist, etc.

Please select ‘Other’ only if none of the other job categories do not apply to your position. If selected, you must enter your job category/relation in the text box.