General Inquiry

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Please fill out the form as fully as you can to help us review your request. We look forward to getting in touch with you.

We will respond with some detailed information by email. Our goal is to respond as soon as possible but due to the nature of our work you can expect a response within 5 business days.

General Inquiry

Your Name*
First Last
Your Email*
Your Phone Number*
Your Address*
Street Address Address Line 2 City State ZIP Code
How did you find us?*
- Agency
- Another Chapter of The Arc
- Another Trust Client
- Attorney
- Facebook
- Google (or other search engine)
- LinkedIn
- Friends or family
- Support Coordinator
Relationship to Individual with Disabilities*
- Self
- Parent
- Other relative
- Caregiver
- Agency
- Attorney
- Financial Planner
- Legal Representative
- Representative Payee
Type of Disability*
Choose all that apply. Use the Shift key to select more than one.
Age of Person with a Disability*
Where the person with a disability currently lives*

Please name county and state.
I have a question about:*
Select one or more topics, if needed. Use the Shift key to select more than one.
What is your question?
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