Requesting Assistance

Are you in need of assistance from Disability Rights Florida? Fill out the Online Intake form below to connect with our staff.

Online Intake Form

Terms and Conditions
(Please select ACCEPT at the end of this page to proceed)

A.  Disability Rights Florida is a non-profit legal organization created by and primarily funded by 9 Federal Grants to assist Florida residents with legal problems arising from disability-related issues. Due to our limited resources, DRF does NOT accept or handle cases in the following areas:
  1. Issues not related to the individual’s disability.
  2. Representation for criminal, probation or parole matters. 
  3. Cases involving a person applying for SSI or SSDI benefits for the first time or assisting with the appeal of a denial of SSI or SSDI benefits by the Social Security Administration. (EXCEPTION: If you are already receiving SSA benefits and have questions about returning to work; or, experiencing a barrier to gain, regain or maintain employment.
  4. Representation on family law-related matters, including but not limited to, divorce, property settlements, child support enforcement, or child custody disputes. (EXCEPTION: If your case involves the Department of Children & Families Protective Services (DCF) threatening to remove child(ren) because of a parent’s disability, please continue to the service request).
  5. Issues involving a person seeking guardianship over the estate of or over the person with a disability. (EXCEPTION: If your case involves seeking a removal of or a challenge to a proposed guardianship, please continue to the service request).
  6. Matters involving worker’s compensation insurance and/or benefits.
  7. Matters involving disputes with private health care insurance companies. (Exception: If your issue involves a private insurance company that is also your Medicaid Managed Healthcare Organization (MCO), please continue to the service request).
  8. Issues involving assistance in finding and securing housing, securing housing vouchers, housing waitlists, rental assistance, security deposits, finding employment, or securing financial/monetary assistance. 
  9. Evictions related to non-payment of rent or housing condition issues not disability related.
  10. Being sued for non-payment of a bill, a dispute with a contractor, warranties, or product defects.
  11. Bankruptcy, consumer law and poor customer service.
  12. Wills, Trust & Probate
  13. Personal Injury
  14. Real Estate & Property 
  15. Professional Malpractice
If you believe your issue falls under one of the above areas, please visit our Helpful Resources page to find other services that may be better able to assist you 

B.  This form of communication between Disability Rights Florida and an individual does NOT create an Attorney-Client relationship.

C.  In order to protect your personal information, please remember to “log out” of the program and close all browser windows when you have completed the form. Doing this is very important, especially if you are using a computer or devices that are shared by others, like those found at the public library, a school, or the like. Disability Rights Florida is NOT responsible for a user’s failure to protect his or her information. In order for the application to be processed and considered by DRF, it is necessary that all of the required fields are completed and answered.

D.  DRF appreciates your cooperation in these matters.

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Please complete as much information as possible.

We strive to make our online intake form as accessible as possible. If you have any difficulties using this form, please feel free to contact us via phone at (800) 342-0823 or via TDD at (800) 346-4127.

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Information Related to the Person with a Disability





















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Person Completing Form on Behalf of Person with a Disability
If you are contacting Disability Rights Florida about an individual with a disability, and you are the parent or guardian, or the individual is unable to make contact due to his/her disability, you are required to complete the following information about yourself.














Important: Please confirm you have entered correct information BEFORE clicking the "Next Page" button.

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Living Arrangement




Reason You Are Contacting Disability Rights Florida










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Miscellaneous Questions








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