Get Started Today

For scheduling an American Sign Language Interpreter
you MUST call or email our
Mid Hudson Interpreter Department:
845-452-3913 EXT.102 or MHIS@taconicresources.org.
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If you’re having any difficulty with the forms below you may call our front desk at (845) 452-3913
Monday – Friday 9AM – 5PM
((We are closed on all Federal Holidays))
Videophone for Deaf/Hard of Hearing ONLY:
(845) 345-8416
TTY: (845)485-8110

GET STARTED:

After you submit the form, someone will contact you
within a few business days to confirm receipt.

*Depending on the type of service you are requesting, if you are not a resident of Dutchess County, NY you could call and ask the front desk staff first before submitting a Request Form. Or you can find your local ILC for your county by using the search tool within the ACCES-VR website: https://www.acces.nysed.gov/vr/independent-living-centers

GENERAL REQUESTS FOR INFORMATION & REFERRAL
CLICK THE RED BOX BELOW:

Click Here to Submit a HIPAA-compliant Request Form for General Information & Referral

*The Parent/Child Intake Packet and individual forms for Consumers under age 18 are only available after you have a phone consultation with the Special Education Advocate. The Advocate or their Assistant will then send you the forms via e-mail, mail, or fax. Or you will be able to complete the forms during your in-person appointment with your Special Education Advocate.

Our adult and child Intake paperwork will take less than 5 minutes of your time to complete! It will include the following forms:

Intake Form – As a government-funded organization, we are required to ask typical questions about your demographics; age, race, sex, employment/education status and disability information, etc.

Informed Consent to Release/Receive Information – for us to obtain/reveal information when contacting another organization/individual while working with you. If you have questions, your TRI Advocate or front desk staff will explain how to fill it out correctly. Do NOT submit a TRI consent form if you have not previously submitted an Intake Packet. If you are currently working with another agency, have that agency fax over their own consent form, signed by you. Only submit a TRI consent form if a TRI Advocate instructs you to.
For TRI Consumers ONLY: Click Here for the Adult Informed Consent form.

ACCES Release of Information – Several of our funding sources conduct occasional reviews of our programs to ensure quality. You can choose whether or not to give authorization for your records to be included in those reviews. Returning Adult Consumers must renew this annual form after September 30th. For Adult Consumers, Click Here to update your file.

Welcome letter – We explain our mission and philosophy, confidentiality policy, and other important information about your rights.

SPECIAL EDUCATION ADVOCACY ONLY:
WELCOME MESSAGE AND SELF-DIRECTION LETTER

Independent Living Plan – If you choose, you can receive assistance in developing a plan to accomplish your self-identified goals. This form will get you started and is done with your Advocate.

*Additional Information Form -This is an additional form to the initial Intake Packet for adult and child consumers. A new form is to be completed for all returning consumers, or if your information has changed. If you have any questions about this form, you may ask the front desk to assist you. Click HERE for the Additional Information Form.

Click Here if you have been instructed to complete our online Adult Intake Packet

***If you are having difficulty, call or email to request the intake packet to be mailed or emailed to you as a PDF. Do NOT print the online forms to submit. They will be invalid.

*This HIPAA-compliant Intake requires a signature to be drawn with a computer mouse, tablet, or smartphone. Adult Intakes are solely for the individual with the disability who is seeking services. Without the individual’s signature, the online intake is invalid*.