Protection and Advocacy Services Forms
To search this catalog: From the toolbar in the Edit menu, select "Find". When the Find search box appears, enter a keyword or form number. The first search result will display with the keyword or number highlighted, at the top of the page. Click "Find next" until the desired form is highlighted.
For forms labeled "PDF", the free Adobe Acrobat Reader software is required to view and in some cases fill them out. Forms in other formats (MS Word, MS Excel, etc) are indicated where appropriate.
To open a form once you have chosen it, click on the linked State Form Number (such as 01365.pdf).
For questions about individual forms, please contact this agency's forms coordinator, Elizabeth Najar at 317-722-5555.
For questions about how to use this catalog, or to inform us of a technical problem, please send e-mail to the Forms Management Division.
Forms marked "read-only" cannot be filled in on your computer. They must be printed out and filled in by hand or typewriter.
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Title |
Form Number |
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Case Log (read-only) |
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Client Satisfaction Survey (read-only) |
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Computer Use Agreement (read-only) |
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Information / Referral Survey (read-only) |
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Legal Representation Agreement |
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Long Distance Record |
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Post Test Evaluation |
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Qualified Mental Retardation Professional Designee Training Registration (read-only) |
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Record of Individual Itinerary |
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Record of Out-Going Mail |
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Report of Serious Occurrence (read-only) |
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Report of Serious Occurrence |
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Request for Approval of Expenditure |
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Request for Approval of Expenditure |
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Request to Release Information |
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Revenue Received Log |
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