Houston Disability Community Needs Assessment
***COMPLETING THIS FORM DOES NOT GUARANTEE YOU WILL RECEIVE ASSISTANCE***
The Houston Mayor's Office for People with Disabilities is working to identify the immediate needs of Houstonians with disabilities following winter storm Uri. This form is intended to:
• Identify existing needs and gaps in services specific to Houstonians with disabilities
• Inform local and regional disaster response and recovery policies, programs, and services

MOPD staff are available to provide constituent services and referrals by phone at 832-394-0814 and by email at mopdmail@houstontx.gov, Monday through Friday, from 8:00 AM to 5:00 PM.
Do you understand that completing this form does not guarantee you will receive assistance and that the information being collected through this form will be used for disaster response and recovery planning purposes? *
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