ADAP Client Intake Form

 Please compete this form if you would like to schedule an appointment to speak with an intake advocate about a disability related issue. Complete as much information as possible. If you have difficulties using this form, please feel free to contact us via phone at 800-826-1675 or 205-348-4928.
*Required

NOTE: Filling out this form is not an indication of an attorney / client relationship and does not guarantee legal representation. All information is kept confidential.

    Information About the Person with a Disability

    Primary Contact Information

    Reason for contacting ADAP
Alabama Disabilities Advocacy Program (Main Office)
The University of Alabama
Box 870395
Tuscaloosa, Alabama 35487-0395
Physical Location: 624 Paul Bryant Drive
                             500 Martha Parham West
1-205-348-4928 (Phone)
1-205-348-3909 (Fax)
1-800-826-1675 (for clients - instate only)
e-mail: adap@adap.ua.edu
website: http://adap.ua.edu