EVV Resources

Live-In Caregiver Attestation Form

Please click HERE to find the Live-In Caregiver Attestation form.

  • Please make sure that all instructions on the form are followed.
  • Lifelong does NOT have the authority to grant exemptions.
  • Please send completed form to Lifelong via email, fax or drop it off at the office/secure drop box.
  • Once the form is received by MCCMH, they have 10 calendar days to provide a decision to the FMS, caregiver and person served.