Parents please continue to contact ELRC Region 18 with questions regarding your eligibility by calling 215-382-4762 or sending an email to email@example.com.
- ELRC Region 18 has drop boxes available at our Northeast Philadelphia office (2361-2373 Welsh Road, Philadelphia, PA 19114), our North Philadelphia office (2816 Germantown Avenue, Philadelphia, PA 19133), and in our West Philadelphia office (5548 Chestnut Street, Second Floor, Philadelphia, PA 19139) Mondays through Fridays from 8:00 am to 5:00 P.M.
- ELRC Region 18 now offers Saturday hours at our Main Office ONLY (2361-2373 Welsh Road, Philadelphia, PA 19114) from 8:30 am to 4:30 P.M.
- Need to complete a form for ELRC Region 18? Scroll down for a list of available ELRC Region 18 forms. Forms can be printed or completed online and submitted electronically via email to firstname.lastname@example.org
- Need help finding a provider? Search the online childcare tool or call us at 215-382-4762.
- Remember to utilize COMPASS to submit your redetermination or new application by visiting: compass.state.pa.us. ·You can also use COMPASS to apply for cash assistance, food stamps (SNAP) benefits, medical and more!
- Supporting documentation can be sent electronically via fax (215-382-1199) or via email (email@example.com).
Printable ELRC Client Forms
Please click on the ELRC client form to print. Completed forms can be sent via email (firstname.lastname@example.org), fax (215-382-1199) or mail (ELRC Region 18, 2361-2373 Welsh Road, Philadelphia, PA 19114).
- FPIG – Co-pay Chart
- Anticipated Self-Employment Income and Schedule of Care
- Authorization for Release of Information
- Authorization for Release of Information Español
- Cash Earning Form
- Class-Training Schedule Verification
- Education Schedule Verification
- Eligibility Requirement
- Employment Verification Form
- Employment Verification Form Español
- Medical Assessment Form
- Notice of Privacy Practices
- Parent Schedule Review
- Self-employment Schedule of Care
- Self-Employment Verification
- Self-Employment Verification Español