MEDICAID FORMS

Student Info Sheet
Use this form to add or change student information in the RELAY Service Portal.  Make sure to download the form so you can fill it in as a PDF file and send the form using ShareFile.

Child Profile Form
This form should be filled out for paraprofessional Services and signed by a physician.  Services on the form should match what is included in the IEP and should be updated at least annually.  Please send a copy of the form using the ShareFile link.

Personal Care Services Daily Sheet
Daily paraprofessional tasks should be logged daily.  This form can be used to help add service times to the RELAY Service Portal and should be kept in a student file for 6 years, 3 months in case of a service audit.
RELAY Service Portal Instructions
Therapy providers can access these instructions for using the portal.

RELAY Service Portal Paraprofessional and Nursing Instructions
Paraprofessional aides for personal care services and nurses use this manual for instructions on entering services into the portal.

Saving Student Goals in the RELAY Service Portal
When a student is initially added to a therapy providers caseload, goals can be uploaded to a student account.

​Saving groups in the RELAY Service Portal
Use these instructions for creating groups in the portal. ​
Please use the Sharefile link to send student forms, or
​fax forms directly to our office at (406) 624-6289. Any form that includes student names and information should be sent via Sharefile. 
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Please do not send student names and information via email.
Questions? Contact Lisa!
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E-mail: lwaterman* (see footer)
Office (406) 272-0073  |  ​Fax (406) 624-6289