Access to Independence, Inc.
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Request for Services from Access to Independence
If you have a disability-related question or issue you’d like assistance with, please complete the boxes below and an Independent Living Specialist will contact you in the method you prefer within 1-2 business days. Please double-check which method you’d like us to contact you (phone or e-mail) and double-check that the contact information is correct. We look forward to assisting you!
*
Indicates required field
Name
*
First
Last
Address
*
City
*
Zip Code
*
Phone number
*
If you prefer email contact us at info@accesstoind.org
State
*
If you prefer email
contact us at
info@accesstoind.org
County
*
Dane
Dodge
Green
Columbia
Other- WI
Other- Outside WI
Comment
*
Submit
All requests for services will be responded to no later than 2 business days after the request. Please contact ATI at 608-242-8484 or by e-mail at
info@accesstoind.org
if you do not receive a response after 2 business days.
Thank You!