DRNY's Online Intake process is under construction please contact us by email or telephone if you need immediate assistance.
Phone: (518) 432-7861
TTY: (518) 512-3448
Toll Free: (800) 993-8982
Fax: (518) 427-6561
You can begin DRNY's intake process by completing the form below. You can submit the form even if you do not have all the information requested. After you submit your request, a member of DRNY's intake staff should attempt to contact you within 5 days.
Our services are reserved for individuals with disabilities. If you are contacting Disability Rights New York about an individual with a disability, we will ask you to have the individual contact us directly, unless you are:
• The parent of a minor child,
• The guardian, or
• Other representative authorized by the individual with a disability.
Online Intake Forms are processed only during normal working hours on regularly scheduled work days. We will personally contact you as quickly as possible; however, it may take up to four (4) working days for a staff member to contact you. If you have not received a reply in that time, please contact us again. The intake process is designed to maintain confidential information within Disability Rights New York.
Please complete as much information as possible. If you have any difficulties using this form, please feel free to contact us via phone at (800) 993-8982 or via TTY at (518) 512-3448.