One Call Now Sign-up: Ashtabula County Board of Developmental Disabilities
What is your name?
What is the name of the person receiving services?
Please provide your phone number, you may list up to six phone numbers:
Please check if you would also like to receive additional notification of events for the following:
Service & Support Administration
Health & Welfare Alerts
Are you an agency provider or independent provider?
I am not a provider
If you are a provider, what is the name of your agency?
I hereby grant permission to ACBDD to use the information provided for the purpose of notifying me of program announcements. I understand that ACBDD and its communications service provider will not sell, lease, rent or give any personal information to a third-party entity and that personal information will not be released unless there is a legal obligation to do so.
I give permission
I DO NOT give permission
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This form was created inside of Ashtabula County Educational Service Center.