If you have a disability, the Division of Rehabilitation Services may be able to help you find a job or live at home independently.
To apply for services, begin by completing the form below. Once you have submitted this form, a counselor will contact you to set up an appointment to complete the application process. During this appointment, we will discuss your goals, the nature of your disability, and the services we can provide.
To learn more about the types of services available, please see Rehabilitation Services.
Required fields are denoted with an asterisk (*). An incomplete referral may cause a delay in the referral process. Please ensure you have completed as many fields as possible. If additional information is available after submitting the referral, you may contact the local DRS Field Office by using the DHS Office Locator.