Complete our online intake form and click Submit when you are finished.
DRP needs information related to the person with a disability to determine eligibility for services and for our statistical reporting purposes. All information provided is confidential. Providing us with complete and detailed information about the person with the disability will allow us to respond to you more quickly and efficiently. Questions marked with an (*) must be answered. You will not be able to submit the form unless the required information is filled in (you can answer "don't know", "prefer not to disclose", or "does not apply" if necessary). If you are unable to complete the questions without assistance, please call 800-692-7443.
We provide an array of services to eligible individuals on issues that fall within our priorities and our case selection criteria. DRP does not charge for services. DRP cannot assist every individual who contacts us, but you should hear back from a DRP staff person within 5 -7 business days of your request.