Below you will find the forms necessary to enroll an individual into Allegany Arc services. If you have any questions, please contact Kila Cook, Associate Director for System's of Care at (585) 593-3005 Ext. 237 or kila.cook@alleganyarc.org.

Click here to download Allegany Arc's Information & Enrollment Brochure.

Day Services
Day Habilitation, Individualized Community Services, Respite, Evening Recreation, Family Care, Saturday Recreation, Teen Recreation, After School Program, and At-Home Residential Habilitation
        Application for Services 
        Personal History 
        Physical Examination Form 
        Over the Counter Form 
        Consent for Release of Confidential Information

Residential Services
IRA's - provide 24 hour staff oversight to 65+ individuals located in Wellsville, Scio, Belmont and Alfred, and Supportive Apartments - teaches household management and independence skills
        Application for Services 
        Personal History 
        Physical Examination Form 
        Over the Counter Form 
        Consent for Release of Confidential Information
        OPWDD Priority Sheet for NYS-Cares

ACHIEVE Vocational/Educational Services
Vocational Assessment/Employment Screening, Youth Transition Services, College Mentor Program, Job Readiness Classes, Job Training, Community Based Assessment, Job Placement, and Employment Support Services
        Application for Services 
        Personal History 
        Physical Examination Form 
        Consent for Release of Confidential Information