
Alabama Disabilities Advocacy Program
PROVIDER INTAKE REFERRAL FORM
PROVIDER INTAKE REFERRAL FORM
The Alabama Disabilities Advocacy Program (ADAP) provides FREE legal services to Alabamians with disabilities to protect their civil rights. We help with issues like special education, Medicaid, community integration, assistive technology, and ADA violations.
By completing and signing this intake referral form, you are:
By completing and signing this intake referral form, you are:
- Authorizing the provider listed below to share it with ADAP.
- Authorizing ADAP to contact you so we can discuss your child’s disability-related legal rights concerns with you to see what, if any, help we can offer.
- Entering into an attorney-client relationship with ADAP. ADAP will not become your attorney unless and until we provide you with a written agreement that describes the scope of the services that we will provide.
Provider: Please submit the completed form, print, sign and email it to adap@adap.ua.edu
or print, sign and fax to ADAP at (205) 348-3909. Questions? Contact ADAP at (205) 348-4928
or print, sign and fax to ADAP at (205) 348-3909. Questions? Contact ADAP at (205) 348-4928