Are you interested in receiving services from Independence, Inc.?
The process is simple:
- We serve all ages, at any stage of life
- To receive our services, you must self-identify and self-report as having a disability – we do not require any medical documents proving you have a disability.
- having any type of disability qualifies you to access our services, whether it’s a physical disability, learning disability or developmental delay, cognitive disability, mental/emotional/behavioral disability, brain injury, chronic health condition etc.
- We will ask you to fill out a short intake form (required) so that we can gather some information from you, including what services you are interested in
- We will ask you if you would like to fill out an optional Independent Living Plan to help you set your goals and work together to provide action steps to reach those goals
- We will give you a HIPAA Notice to sign (required) describing Privacy Practices based on the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- And finally, we will give you the Independence, Inc. Grievance Policy and Procedure in the event you have a complaint or grievance against any staff or service at Independence, Inc.
You can find these forms below to print, fill out, sign and return:
Independent Living Plan (optional)
Consumer Rights and Grievance Procedure