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Need Our Assistance?

You may complete and submit this form to request services for an issue directly related to a disability. A current phone number is required so that an advocate can contact you for further information that will be used to determine the level of service our agency can offer you.

You may also:

  • Come into our office for an interview in person between 8 am to 4:30 pm Monday-Friday at 134 South 13th Street, Suite 600 Lincoln, NE 68508 or 1425 First Avenue Scottsbluff, NE 69361
  • Call to speak to an advocate between 8 am and 12 pm, Monday through Friday at 402-474-3183 or 800-422-6691

If you are contacting Disability Rights Nebraska about an individual with a disability other than yourself, we will ask you to have the individual contact us directly, unless you are:

  • The parent of a minor child
  • The guardian, or
  • Other authorized representative
If you are other than the individual requesting assistance, please provide the following information for that individual.
Disability (check all that apply)
Do you receive:
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