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Pediatric In-Home Care (GAPP)
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Home
About Us
Services
Pediatric In-Home Care (GAPP)
Adult & Senior In-Home Care
Senior Placement Services
Advanced Mobile Wound Care
Paid Family Caregiver
Testimonials
FAQs
Contact
Payments
Contact Us
ReadyMed GAPP Eligibility Form
Purpose: To determine if your child qualifies for in-home care services under the Georgia Pediatric Program (GAPP).
1. Child's Medical Conditions (Select all that apply)
Cerebral Palsy
Muscular Dystrophy
Down Syndrome
Spina Bifida
Hydrocephalus
Traumatic Brain Injury (TBI)
Quadriplegia
Paraplegia
Autosomal Deletion
Chromosomal Abnormality
Angelman Syndrome
Rett Syndrome
Wheelchair-bound
Other
Details:
Note: Autism Spectrum Disorder (ASD) alone is not a qualifying diagnosis for GAPP.
2. Residency
Yes, we reside in Georgia.
No, we do not reside in Georgia.
3. Care Preferences
I wish to be paid as my child's caregiver.
I prefer professional in-home nursing services.
I'm interested in both options.
4. Medicaid Status
My child has Georgia Medicaid.
My child has a Katie Beckett Waiver.
My child has neither.
See:
https://www.mmis.georgia.gov
and
https://pamms.dhs.ga.gov
5. Child's Age
Under 8 years old
8–20 years old
21 years or older
6. Contact Information
Full Name
Email Address
Phone
Submit for Eligibility Review
