Program Forms

Spring 2025 Forms are due by 5:00pm on Monday, February 10^th

The following forms must be completed once a year. Not sure if your forms are due? Contact our office at 410-704-4486.

The forms below are completed online securely using Adobe Docusign:

Health Care Protected Information Disclosure Form

Request for Service

Participant Agreement Form

Participant Information Form

Participant Agreement For Transportation Form (Each Semester)

It is important that all forms are completed in full and returned to the Hussman Center prior to the start of programs. If forms have not been completed, the Hussman Center reserves the right to delay a participant’s admittance to their program until forms are submitted.

The forms below are completed online securely using Adobe Docusign:

If you’re a NEW CAPS participant or have not participated in more than 1 calendar year, your Forms for the Spring semester are due Friday, January 17^th

All Returning participant CAPS Forms for Spring 2025 are due Monday, January 20^th

All CAPS Payments will be due Monday, January 27^th, 2025

Health Care Protected Information Disclosure Form

Request for Service

Participant Agreement For Transportation Form (Each Semester)

CAPS Participant Information Confirmation Form

CAPS Participant Agreement Form

The form below is completed online securely using Adobe Docusign:

Lisa Higgins Applications are accepted for the Fall and Spring semesters.

The Lisa Higgins Application’s for the Spring 2025 CAPS Program are due Friday, January 27^th. Responses to Lisa Higgins applications for the Spring 2025 CAPS Program are expected by Tuesday, January 21^st.

Lisa Higgins applications for Spring 2025 Group programs are due by Monday, January 27^th, 2025. Responses to Lisa Higgins applications for Spring 2025 Group Programs are due by Friday, January 31^st. 

Lisa Higgins Application