Refer Someone to ARI

Are you a person with a disability interested in learning more or getting started with ARI? Or are you a loved one, caretaker, etc. of a person with a disability and would like to refer them to ARI?

Please complete the form below and refer either yourself or someone else to ARI. We will respond as soon as possible by phone or email to get started!

Referral Form

Person being referred





Is this a self-referral?

If you are referring someone else, please complete the remainder of the form before submitting it. If this is a self-referral, you can skip the next section.

Your Information (if referring someone else)