Kaleidoscope Kids

PTP Client Intake Forms (English)

PTP Client Intake Forms (Spanish)

PTP Referral Form

Georgia Medicaid Eligibility & Application Instructions

Georgia Medicaid Application (English)

Georgia Medicaid Application (Spanish)

Understanding Medicaid

PTP Short Brochure

PTP Full Brochure

Records Requests

We are able to provide requested records as authorized by our our clients, except for cases funded by the Georgia Division of Children and Family Services (DFCS). For DFCS-funded cases, please submit a GA Department of Human Resources Release of Information (Form 5459R) directly to DFCS for these records.

We require two (2) completed forms, a PTP Documentation Request form, and a PTP Authorization To Release/Receive Information form.

Applicable fees and further instructions are included on the forms.

**IMPORTANT** You must DOWNLOAD and SAVE copies of fillable forms to your computer BEFORE entering your information.

Please fax completed, signed forms to 404-378-2394, or email them to us.