Intake/Request Support
Our services are provided at no cost to families. Our services and supports focused primarily on intellectual and/or developmental disabilities. Our supports are educational in nature and provide you with various tools and referrals specific to your needs. Please note that we generally do not attend IEP meetings.
Your name
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First Name
Last Name
Your phone number
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-
Area Code
Phone Number
Your email address
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Name of individual needing assistance
Your relationship to the individual
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What is their disability?
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How old is s/he?
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Where does the individual live?
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Winchester
Frederick County
Clarke County
Shenandoah County
Other
What are your concerns?
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Application or eligibility for services
Difficulty accessing services
Finding service providers
Transitioning to adulthood
Medicaid waivers
Special education & Section 504 plans
SSI/SSDI
Guardianship and supported decision making
Financial supports
Special needs trusts and ABLE accounts
Employment supports & day programming
Residential supports
Other
Briefly describe your concern and how we may assist you.
How were you referred to us?
Friend
Service provider
DSS
Counselor
Educator
Other
How would you like to be contacted?
Phone
Email
Text message
Submit
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