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Advancing the Human & Civil Rights of People with Disabilities in Illinois

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Online Intake Form

Please Read

Before you complete our Online Intake Form, please read How to Get Help from Equip for EqualityThis will help you understand the types of cases we work on, how we handle requests for legal help and what to expect during the process.


Online Intake Form

I Need Legal Help With:
(Please see the Cases We Don't Handle before you make your selection)

Access to Assistive TechnologyDisability DiscriminationEducation – Special Education or Early InterventionEducation – Post-Secondary EducationEmployment DiscriminationGuardianship (Being My Own Guardian)Housing (Fair Housing Discrimination)Living in the CommunityRights in Institutions – Abuse & NeglectRights in Institutions – Other than Abuse & NeglectTransportationVotingOther

My Contact Information (* Required)

*First Name

*Last Name

*Street Address

*City

*State

*Zip Code

*County

*Email Address

*Confirm Email Address

Telephone Numbers

Home:

Cell:

Work:

Initial Intake Questions (*Required)

*Are you filling out this form for yourself, or for someone else?



Please know that in order to complete the intake and determine we can help someone, we may need to speak directly with the individual with the disability.

*Do you, or the person for whom you are filling out this form, have a disability?

*Is your legal problem based in Illinois?

*Please briefly describe the legal problem

*What would you like EFE to do to help you with your legal problem?

*What do you think is the highest unmet legal need for people in Illinois?

*How did you hear about Equip for Equality?

*Are you a registered voter?

*If you are not a registered voter, would you like our office to send you voting materials?

*Would you like to receive EFE’s E-Newsletter?

*Please read EFE's Disclaimers and agree to the terms.
Yes, I agree to the terms of EFE's Disclaimers

 


What Next?

After you complete this Online Intake Form, if you do not receive a reply from us within 3 working days, please contact us again by telephone, TTY, Fax, or regular mail at:

Phone Numbers:
312-341-0022 (Voice)
800-537-2632 (Toll Free Voice)
800-610-2779 (TTY)

Fax:
312-341-0295

Mail:
Equip for Equality, ATTN: Intake, 20 North Michigan Avenue, Suite 300, Chicago, Illinois 60602


 

Last updated: August 13, 2018

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