Employment and Independence for People with Disabilities Information Request

Submitted by jduran2 on Wed, 05/19/2021 - 17:58

Request Information and Assistance
Use this form to request information about division programs, services, and activities or to report a technology-based barrier on our website.

Please note that communications via this web form are not secure and your request should not include any personal medical information.

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Type of Request

Employment Services for People with Disabilities

Independent Living Services for People with Disabilities

Disability Awareness and Workplace Inclusion

Media Inquiry

Technology-based barrier to accessing website

Other…

First Name

Last Name

Phone Number

County

In the box below, type your request or describe the issue you experienced while on our website. If you are reporting a technology-based barrier, include a link to the inaccessible webpage and list the type of assistive technology used.