APD > Applying for Services

Applying for Services

To apply for services from the Agency for Persons with Disabilities, which includes waiver participation or placement in an intermediate care facility for the developmentally disabled (ICF/DD), submit an application to the APD office that serves your area, either by mail or by hand delivery. Faxed submissions will be returned for an original signature.

Application Download

  • Application for Services
    DOC | PDF
  • Solicitud español
    DOC | PDF

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Regions

  • Northwest Region - Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Okaloosa, Santa Rosa, Wakulla, Walton, and Washington counties - Fields 1 and 2

  • Northeast Region - Alachua, Baker, Bradford, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Lafayette, Levy, Madison, Nassau, Putnam, St. Johns, Suwannee, Taylor, Union, and Volusia counties - Fields 3, 4, and 12

  • Central Region - Brevard, Citrus, Hardee, Hernando, Highlands, Indian River, Lake, Marion, Martin, Okeechobee, Orange, Osceola, Polk, Seminole, St. Lucie, and Sumter counties - Fields 7, 13, 14, and 15

  • Suncoast Region - Charlotte, Collier, DeSoto, Glades, Hendry, Hillsborough, Lee, Manatee, Pasco, Pinellas, and Sarasota counties - Suncoast Field (23) and Field 8

  • Southeast Region - Broward and Palm Beach counties - Fields 9 and 10

  • Southern Region - Dade and Monroe counties - Field 11