Program Forms

Summer 2024 Forms are due by 4:00pm on Monday, June 17^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

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 Fall semester are due Friday, August 16^th

All Returning participant CAPS Forms for Fall 2024 are Monday, August 19^th

All CAPS Payments will be due Monday, August 26^th, 2024

Health Care Protected Information Disclosure Form

Request for Service

CAPS Returning Participant 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 Fall CAPS Program are due Thursday, August 22^nd. Lisa Higgins applications for Fall Group programs are due by Wednesday, September 4^th, 2024. Responses to applications are due by September 6^th.

Lisa Higgins Application