top of page

Apply for General Services

The Center for Independence has been serving people with disabilities on the Western Slope of Colorado since 1982. Our services include peer counseling, personal systems advocacy, information and referral, support groups, transitional support, classes and education. Our services are available to people with all types of disabilities. 

​

Complete the form below to apply for general services. General services include housing, transition, youth, peer support, advocacy, deaf/hard of hearing, independent living skills, blind/low vision and youth vocational assistance. A staff member will contact you within 10 days of applying for services to setup initial interview. 

​

If you prefer a physical application we have them available at your local office. If you need assistance filling out the application please contact us to set an appointment. 

Dad-son signing_web.jpg
Services Requested - Select All That Apply
Do you have a disability?
Yes, documented
Yes, undocumented
No
We have a separate form for disability benefit cases (SSI/SSDI). We ask that you complete this before submitting this form if you are seeking disability benefits assistance (SSI/SSDI).
I am not seeking disability benefits (SSI/SSDI) assistance
I am seeking disability benefits (SSI/SSDI) assistance and have submitted that form
Birthday
Gender
Veteran Status
Ethnicity
Marital Status
Education
Preferred Contact Method - Select All That Apply
Registered Voter
Yes
No
No, but interested in learning
Employment Status
Income Level
bottom of page