 General Elegibility
To be eligible for services, the child or youth must:
- Be an Arizona resident under 21 years of age,
- Have an identified physical disability, chronic illness, or medical condition that is potentially disabling.
Early referral is encouraged to assure the most successful results.
 Anyone, including doctors, nurses, patients, or friends may refer a child to Children's Rehabilitative Services.
A Pediatric History form and CRS Financial Application need to be completed to apply for services. These forms are available here or by calling the clinic closest to you. Medical documentation, if available, needs to be provided along with the application.
Things to bring to your CRS Financial Eligibility Interview:
AHCCCS PATIENTS: If your child/children are currently enrolled in AHCCCS, you need to bring the patient AHCCCS number or AHCCCS ID card, some form of identification for yourself, guardianship papers, proof of residence, social security number, age verification and, if you have private medical insurance, your insurance card.
AHCCCS Members and Applicants now required to provide additional documentation of U.S. citizenship and identity
ALL OTHER PATIENTS: The following information and verification is required to complete your Financial Eligibility application. Bring the following for each member of your immediate family.
- Health Insurance (Bring insurance card; name and address or Insurance Provider; and prior authorization form, if this is a requirement of the insurance company.)
- Guardianship papers (If you have been made a legal guardian, bring court documents.)
- Proof of Residency (Bring mortgage payment stub, utility bill or statement from landlord, including the landlord's name, address and telephone number.)
- Social Security Numbers (for parents and child/children)
- Proof of Child's Age (birth certificate, baptismal certificate, school record, etc.)
- Earnings, Self-employment (last 30 days - pay stubs or statement from employer or federal income tax return with date and signature)
- Unearned Income and Child Support (check stubs, court orders, award letters from The Social Security Administration (SSA), etc.)
- Child Care (bills and paid receipts)
- Medical Expenses (doctor bills, drugstore receipts, hospital bills, insurance premium notices, medical equipment receipts)
- Paid Medical Expenses: Medical, dental and insurance premium expenses which were incurred and paid by any family member in the past 12 months.
- Unpaid Medical Expenses: Medical and dental expenses which were incurred by any family member and which remain unpaid.
- Identification for parent or legal guardian (driver's license, state I.D. card, etc.)
You may be asked at the interview to provide additional information.
Documents in alternative format are available upon request to by calling Yuma CRS at (928) 336-7095 or 1-800-837-7309.
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