Mental Retardation Services Intake

To apply for Mental Retardation Services, an applicant must complete the intake process. The following information will guide you through the process of applying for services, including the Medicaid Mental Retardation Waiver.

In order to be eligible for services, the applicant must meet all of the following criteria:

• Be a resident of Fairfax County, Fairfax City, City of Falls Church, or in the custody of Fairfax County Department of Family Services
• Be at least 2 years old
• Have documentation of a diagnosis of mental retardation. This criteria is met by the following:
  • If the applicant is between two and six years of age, a developmental evaluation with a diagnosis of developmental delay or mental retardation; or
  • If the applicant is six years of age or older, a psychological evaluation completed prior to the age of 18 providing a diagnosis of mental retardation with a full scale IQ of about 70 or below. In addition, an evaluation confirming the diagnosis of mental retardation is required to have been completed within the past 7 years.
• Have significant deficits in at least two areas of adaptive living skills (i.e. communication, self care, home living, social/interpersonal skills, use of community resources, self direction, functional academic skills, work, leisure, health and safety)

Print a copy of the intake application (PDF file). Complete all areas of the application and mail to:

Mental Retardation Services
ATTN: Intake Case Manager
12011 Government Center Parkway, #300
Fairfax, VA 22035

If you are unsure if you have already applied for services, or if you would prefer to provide the information by telephone, call 703-324-4400 and ask to speak to an Intake Case Manager.

Upon receipt of the completed intake application, an Intake Case Manager will contact you to obtain any other necessary documentation and to answer any questions you may have. If the applicant is determined eligible, the Intake Case Manager will set up an appointment to meet the applicant.

Additional forms and an assessment are completed during this visit. This face-to-face meeting lasts about an hour and completes the intake process.