Advocating for people with intellectual, developmental, and other disabilities to lead full and equitable lives.

Request Services

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"*" indicates required fields

Name*

Email*

Phone

What service(s) are you working to obtain?*

What is the age of the person in need of service/s?*

What is his/her borough of residence?*

Does the person have Medicaid?*

Yes

Does the person have OPWDD Eligibility?*

Yes

Does the person have a Care Manager?*

Yes

Additional Comments

Phone

This field is for validation purposes and should be left unchanged.