Respite Interest Form

Please fill out this form to the best of your ability for anyone you think may benefit from Respite. This form can take about 5 minutes to complete. Please note that Integral Care Staff will be in contact within 3 business days. This form will not allow earlier requests.

For Respite to be provided, the individual must meet the following requirements:

•                      Be actively enrolled in Integral Care IDD Services

•                      Resident of Travis County

•                      Lives with family/caregiver in own home/family home

•                      Age 4 and up

•                      Respite Support Professionals are not able to provide medical care.

For individuals interested in accessing IDD Respite Services but are not enrolled in IDD Services, please contact IDDInternalRespite@integralcare.org for more information.

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