DRNY INTAKE SHORT FORM

For assistance with disability-related legal issues, please contact our Intake staff using the short intake form below, e-mailing intake@drny.org, calling 1-800-993-8982 or via TTY at 518-512-3448.

 

Please complete as much information as possible.  A phone number is not required, but providing one helps us more effectively handle your intake request.

 

 

If you have any difficulties using this form, please feel free to contact us via phone at 1-800-993-8982 or via TTY at 518-512-3448.

 

*Your Name & Contact Method are required fields.

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