This form is available for anyone who self-directs their DDA services in the State of Maryland. This form can be used to request an Exception to the Published Reasonable and Customary Wages as listed in the Self-Directed Services Manual.
Only the participant's Coordinator of Community Services may complete this form.
Please complete one form per job position.
Please reach out to your DDA Regional Office if you have questions, concerns, or need technical assistance.
*This form was updated May 16, 2025.