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TRI-COUNTIES REGIONAL CENTER

Below you can find all of the forms specific to the Tri-Counties Regional Center.
Form Description
Record of Consumer P&I Funds at Facility This form is used by board & care providers to track the funds they are holding for their consumers. 
Board and Care Intake Packet This file contains all of the required Board & Care forms. 
Independent Living Intake Packet This file contains all of the required Independent Living forms. 
Authorization for Client Check Deposit Authorizes Tracy Stein Management Services, Inc. to deposit money into your client trust account on your behalf. 
Change in Living Arrangement Forms These forms are used to inform Tracy Stein Management Services, Inc. of a change in living arrangement. 
Person Served Wage Notification Form This file contains the Person Served Wage Notification Form. 
Payee Check Disbursement Request Form This file contains the Payee Check Disbursement Request Form. 
Burial Account Information Form This file contains the Burial Account Information Form. 
Independent Living Budget Form  

©2008 TRACY STEIN MANAGEMENT SERVICES, INC. — DESIGNED BY FUEL CREATIVE GROUP, SACRAMENTO, CALIFORNIA