Mayor's Office for People with Disabilities

Client Intake Form

Thank you for completing this intake form below. We will review your information and contact you soon with referrals that may be able to assist you. Disclaimer: Please note that our agency provides only referrals to service providers and resources in the community. We do not directly provide any services and cannot guarantee the quality or effectiveness of any referred services or resources. It is the responsibility of the client to research and make informed decisions about the services and resources they choose.