The completed Form 3037 must include:
The facility director must sign Form 3037, certifying that the information is correct.
Issues the Group Home Informational Sheet (Form 4745) and the Monthly Activity Report for Drug/Alcoholic Treatment Facilities or Group Homes (Form 3037) upon request to approved facilities.
The FCRC Administrator keeps a file of completed Forms 3037 received from drug or alcohol treatment facilities.
A representative of the local FCRC conducts an annual on-site visit to each facility to verify the accuracy of the Forms 3037 received from the facility.
Verify the Forms 3037 by comparing them to the facility's completed DMHDD 1077, Attendance Record, or other official document that verifies the client's residency at the facility.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
IDHS Office Locator
IDHS Help Line
© 2023 Illinois Department of Human Services