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Referral Process

To initiate the referral process for the Department of Integrated Services for Individuals with Disabilities (DISID), please download and complete the following three forms. These forms are essential for DISID to obtain and release relevant information, provide appropriate services, and assess your needs. Please note that all completed forms must be submitted in person at the DISID Director’s Office. Your information will be treated with confidentiality and used only by authorized DISID personnel.

 

Forms to Download:

 

  1. Referral Form – This form allows you to provide basic information about yourself, your disability, and the services you are seeking from DISID.

  2. Consent to Release and Receive Information Authorization Form – This form grants DISID permission to access all relevant information and documents from both government and non-government entities involved in your case. It also authorizes DISID to release your information to relevant entities that may provide appropriate services and assistance. All information obtained or released will be treated with confidentiality and used only by authorized DISID and DSS personnel.

  3. Physician’s Disability Certification – This form serves as a certification that you have met the Americans with Disabilities Act (ADA) definition of an “individual with disability(ies)” according to the ADA disability criteria. It must be completed by your physician.

How to Submit:

Once you have downloaded and completed the forms, please submit the physical copies directly to the DISID Director’s Office located at

138 East Marine Corps Drive J&G Commercial Plaza
Suite C101
Hagatna, Guam 96910.

 

 

 

If you have any questions or need assistance with the referral process, feel free to contact DISID at (671) 475-4624 or dds@disid.guam.gov

We look forward to working with you and providing the support and services you need.

 

Referral Form

This form allows you to provide basic information about yourself, your disability, and the services you are seeking from DISID.

Release of Information Authorization Form

This form grants DISID permission to access all relevant information and documents from both government and non-government entities involved in your case. It also authorizes DISID to release your information to relevant entities that may provide appropriate services and assistance. All information obtained or released will be treated with confidentiality and used only by authorized DISID and DSS personnel.

Physician's Disability Certification

This form serves as a certification that you have met the Americans with Disabilities Act (ADA) definition of an “individual with disability(ies)” according to the ADA disability criteria. It must be completed by your physician.

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