Sample Forms
Resources
For the Visually Challenged
American Council of the Blind
2200 Wilson Boulevard, Suite 650
Arlington, VA 22201
Phone: 202-467-5081
Toll-Free Phone: 800-424-8666
Website: www.acb.org
National information clearinghouse and legislative advocate that publishes a monthly magazine in Braille, large print, cassette, and computer disk versions.
American Foundation for the Blind
2 Penn Plaza, Suite 1102
New York, NY 10121
Phone: 212-502-7600
Toll-Free Phone: 800-232-5463
E-mail: afbinfo@afb.net
Website: www.afb.org
Works to establish, develop, and provide services and programs that assist visually challenged people in achieving independence.
American Printing House for the Blind
1839 Frankfort Avenue
P.O. Box 6085
Louisville, KY 40206-0085
Phone: 502-895-2405
Toll-Free Phone: 800-223-1839
E-mail: info@aph.org
Website: www.aph.org
Deals with the publication of literature in all media (Braille, large type, recorded) and manufacture of educational aids. Newsletter provides information on new products.
Lighthouse International
111 E. 59th St
New York, NY 10022
Toll-Free Phone: 800-829-0500
Website: www.lighthouse.org
A national health association dedicated to fighting vision loss through prevention, treatment, and empowerment.
National Federation of the Blind
200 East Wells Street
Baltimore, MD 21230
Phone: 410-659-9314
Website: www.nfb.org
Membership organization providing information, networking, and resources. Some aids and appliances available through national headquarters. A division called the Diabetics Action Network provides resources for people with diabetes.
National Library Service for the Blind and Physically Handicapped (NLS)
Library of Congress
1291 Taylor Street, NW
Washington, DC 20542
Phone: 202-707-5100
Toll-Free Phone: 888-657-7323
E-mail: nls@loc.gov
Website: www.loc.gov/nls
Free library program of Braille and audio materials circulated to eligible borrowers.
Recording for the Blind & Dyslexic (RFB&D)
20 Roszel Road
Princeton, NJ 08540
Toll-Free Phone: 800-221-4792
E-mail: custserv@rfbd.org
Website: www.rfbd.org
Library for members with print disabilities. Provides educational materials in recorded and computerized form.
The Seeing Eye, Inc.
10 Washington Valley Road
Morristown, NJ 07963
Phone: 973-539-4425
E-mail: info@seeingeye.org
Website: www.seeingeye.org
Offers guide-dog training and instruction on working with a guide dog.
For Amputees
American Amputee Foundation
P.O. Box 94227
North Little Rock, AR 72190
Phone: 501-835-9290
E-mail: info@americanamputee.org
Website: www.americanamputee.org
Offers peer counseling for new amputees and their families. Provides information and referral to vendors. Maintains a list of support groups throughout the United States. Publishes a newsletter.
National Amputation Foundation
40 Church Street
Malverne, NY 11565
Phone: 516-887-3600
E-mail: amps76@aol.com
Website: www.nationalamputation.org
Sponsor of Amp-to-Amp program, in which a new amputee is visited by an amputee who has resumed normal life. Provides information and educational materials.
For Finding Long-Term or Home Care
National Association for Home Care and Hospice
228 7th Street, SE
Washington, DC 20003
Phone: 202-547-7424
Website: www.nahc.org
Largest trade association representing home care agencies and hospices. Free information for consumers about how to choose a home care agency.
For Finding General Health and Doctor Information
American Board of Medical Specialties
222 North LaSalle Street, Suite 1500
Chicago, IL 60601
Phone: 312-436-2600
Website: www.abms.org
Record of physicians certified by 24 medical specialty boards. Directories of certified physicians organized by city of medical practice and alphabetically by physician names are available in many libraries and online.
American Medical Association
515 N. State Street
Chicago, IL 60654
Toll-Free Phone: 800-621-8335
Website: www.ama-assn.org
Help in finding a doctor and other resources for patients.
MedicAlert Foundation
2323 Colorado Avenue
Turlock, CA 95382
Toll-Free Phone: 888-633-4298
Website: www.medicalert.org
To order a medical ID bracelet.
For Finding Diabetes Educators and Dietitians
American Association of Diabetes Educators
200 W. Madison Street, Suite 800
Chicago, IL 60606
Toll-Free Phone: 800-338-3633
E-mail: aade@aadenet.org
Website: www.diabeteseducator.org
Referral to local diabetes educators and other patient resources.
American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606-6995
Phone: 312-899-0040
Toll-Free Phone: 800-877-1600
Website: www.eatright.org
Nutrition information, guidance, and referral to a registered dietitian.
For Finding Foot Professionals
American Board of Podiatric Surgery
445 Fillmore Street
San Francisco, CA 94117-3404
Phone: 415-553-7800
E-mail: info@abps.org
Website: www.abps.org
Referral to a local board-certified podiatrist.
Pedorthic Footwear Association
2025 M Street, NW, Suite 800
Washington, DC 20036
Phone: 202-367-1145
Toll-Free Phone: 800-673-8447
Website: www.pedorthics.org
Find a local certified pedorthist (a person trained in fitting prescription footwear).
For Finding Mental Health Professionals
American Psychiatric Association
1000 Wilson Boulevard, Suite 1825
Arlington, VA 22209
Phone: 703-907-7300
Toll-Free Phone: 888-357-7924
E-mail: apa@psych.org
Websites: www.psych.org and www.healthyminds.org
Referral to your state psychiatric association for referral to a local psychiatrist. Healthyminds.org provides mental health information.
American Psychological Association
750 First Street, NE
Washington, DC 20002-4242
Phone: 202-336-5500
Toll-Free Phone: 800-374-2721
Website: www.apa.org
Referrals to local psychologists and other patient resources.
National Association of Social Workers (NASW)
750 First Street, NE, Suite 700
Washington, DC 20002-4241
Phone: 202-408-8600
Websites: www.helpstartshere.org and www.socialworkers.org
Help finding a social worker in your area.
American Association for Marriage and Family Therapy
112 S. Alfred Street
Alexandria, VA 22314-3061
Phone: 703-838-9808
Website: www.aamft.org
Professional association of marriage and family therapists. Information on marriage and family therapists in your area.
American Association of Sexuality Educators, Counselors, and Therapists
1444 I Street, NW
Washington, DC 20005
Phone: 202-449-1099
E-mail: aasect@aasect.org
Website: www.aasect.org
Professional association of sexuality educators, counselors, and sex therapists. Information on finding a professional in your area and other patient resources.
For Finding Eye Doctors
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
Phone: 415-561-8500
Website: www.aao.org
General information about ophthalmology as well as help in locating an ophthalmologist.
American Optometric Association
243 N. Lindbergh Boulevard
St. Louis, MO 63141
Toll-Free Phone: 800-365-2219
Website: www.aoa.org
Help in finding an optometrist in your area.
For Heart and Other Organ Information
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
Toll-Free Phone: 800-242-8721
Website: www.heart.org
Information about cardiovascular disease and stroke for patients and caregivers.
The Neuropathy Association
60 E. 42nd Street, Suite 942
New York, NY 10165
Phone: 212-692-0662
E-mail: info@neuropathy.org
Website: www.neuropathy.org
For information about disorders that affect the peripheral nerves.
National Kidney Foundation
30 E. 33rd Street
New York, NY 10016
Phone: 212-889-2210
Toll-Free Phone: 800-622-9010
Website: www.kidney.org
For donor cards and information about kidney disease and transplants.
United Network for Organ Sharing
P.O. Box 2484
Richmond, VA 23218
Phone: 804-782-4800
Toll-Free Phone: 888-894-6361
Website: www.unos.org
For information about organ transplants and a list of organ transplant centers in the U.S.
American Chronic Pain Association
P.O. Box 850
Rocklin, CA 95677
Toll-Free Phone: 800-533-3231
E-mail: acpa@pacbell.net
Website: www.theacpa.org
To learn more about chronic pain and how to deal with it.
For Travelers
Centers for Disease Control and Prevention
Travelers’ Health
1600 Clifton Road
Atlanta, GA 30333
Toll-Free Phone: 800-CDC-INFO
E-mail: cdcinfo@cdc.gov
Website: www.cdc.gov/travel
Provides health information for international travelers.
International Association for Medical Assistance to Travellers
1623 Military Road, #279
Niagara Falls, NY 14304
Phone: 716-754-4883
Website: www.iamat.org
Travel advice and membership directory of doctors in foreign countries who speak English and who received postgraduate training in a developed country.
International Diabetes Federation
Chausée de la Hulpe 166
B-1170 Brussels, Belgium
Phone: +32-2-5385511
E-mail: info@idf.org
Website: www.idf.org
An umbrella organization of over 200 diabetes associations throughout the world dedicated to preventing and curing diabetes.
For Physical Activity
American College of Sports Medicine
P.O. Box 1440
Indianapolis, IN 46206-1440
Phone: 317-637-9200
Website: www.acsm.org
For information about health and fitness.
Diabetes Exercise and Sports Association
310 West Liberty, Suite 604
Louisville, KY 40202
Phone: 502-581-0207
Toll-Free Phone: 800-898-4322
Website: www.diabetes-exercise.org
For people with diabetes and for health care professionals interested in exercise and fitness at all levels.
President’s Council on Fitness, Sports, and Nutrition
1101 Wootton Parkway, Suite 560
Rockville, MD 20852
Phone: 240-276-9567
Websites: www.fitness.gov and www.presidentschallenge.org
For information about physical activity, exercise, fitness, and nutrition.
For Schools and Students
Disability Rights Education and Defense Fund
3075 Adeline Street, Suite 210
Berkeley, CA 94703
Phone: 510-644-2555
Toll-Free Phone: 800-348-4232
E-mail: info@dredf.org
Website: www.dredf.org
Law and policy center dedicated to protecting and advancing the civil rights of people with disabilities.
National Dissemination Center for Children with Disabilities (NICHCY)
1825 Connecticut Ave, NW, Suite 700
Washington, DC 20009
Phone: 202-884-8200
Toll-Free Phone: 800-695-0285
E-mail: nichcy@aed.org
Website: www.nichcy.org
Provides information on disabilities in children, laws relating to children with disabilities, and effective educational practices.
National Diabetes Education Program (NDEP)
1 Diabetes Way
Bethesda, MD 20814-9692
Toll-Free Phone: 888-693-6337
Website: www.ndep.nih.gov
NDEP is a federal partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. The NDEP school guide can be found at www.ndep.nih.gov/media/Youth_NDEPSchoolGuide.pdf.
United States Department of Education Office for Civil Rights
400 Maryland Avenue, SW
Washington, DC 20202
Phone: 202-453-6100
Toll-Free Phone: 800-421-3481
E-mail: ocr@ed.gov
Website: www.ed.gov/ocr
Contact the Office for Civil Rights to report any educational discrimination, request information on civil rights compliance programs, and get information on procedures for filing discrimination complaints.
United States Department of Education Office of Special Education and Rehabilitative Services
400 Maryland Avenue, SW
Washington, DC 20202
Phone: 202-245-7468
Website: www.ed.gov/osers
The Office of Special Education and Rehabilitative Services’ mission is to improve results and outcomes for people with disabilities of all ages. It provides support to parents and individuals, school districts, and states in three areas: special education, vocational rehabilitation, and research.
For People Over 50
American Association of Retired Persons (AARP)
601 E Street, NW
Washington, DC 20049
Toll-Free Phone: 888-687-2277
E-mail: member@aarp.org
Website: www.aarp.org
Largest membership organization in the nation, offering services from prescription drug to insurance and other discounts.
National Council on the Aging
1901 L Street, NW, 4th Floor
Washington, DC 20036
Phone: 202-479-1200
Website: www.ncoa.org
Advocacy group concerned with developing and implementing high standards of care and high quality of life for the elderly. Referral to local agencies concerned with the elderly.
For Equal Employment Information
American Bar Association
Commission on Mental and Physical Disability Law
740 15th Street, N.W.
Washington, DC 20005
Phone: 202-662-1570
Toll-Free Phone: 800-285-2221
E-mail: cmpdl@abanet.org
Website: www.abanet.org/disability
Provides information and technical assistance on all aspects of disability law.
Disability Rights Education and Defense Fund, Inc.
3075 Adeline Street, Suite 210
Berkeley, CA 94703
Phone: 510-644-2555
Toll-Free Phone: 800-348-4232
Website: www.dredf.org
Provides technical assistance and information to employers and individuals with disabilities on disability rights legislation and policies.
Equal Employment Opportunity Commission (EEOC)
131 M Street, NE
Washington, DC 20507
Phone: 202-663-4900
Toll-Free Phone: 800-669-4000
E-mail: info@eeoc.gov
Website: www.eeoc.gov
The EEOC is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person’s race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability, or genetic information. It is also illegal to discriminate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit.
For Health Insurance Information
AARP Health
P.O. Box 1017
Mongomeryville, PA 18936
Customer Service: 800-444-6544
Service Line: 800-523-5800
Claims Line: 800-523-5880
Website: www.aarphealthcare.com
The AARP provides comprehensive health care and insurance information. AARP also administers health insurance plans, including individual, group, student, Medicare supplemental, and short-term health insurance.
Medicare Hotline
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244-1850
Toll-Free Phone: 800-MEDICARE
Website: www.medicare.gov
For information and various publications about Medicare.
Social Security Administration
Office of Public Inquiries
Windsor Park Building
6401 Security Boulevard
Baltimore, MD 21235
Toll-Free Phone: 800-772-1213
Website: www.ssa.gov
For information about Social Security.
The Robert Wood Johnson Foundation
P.O. Box 2316
Route 1 and College Road East
Princeton, NJ 08543
Toll-Free Phone: 877-843-7953
Website: www.rwjf.org
An independent philanthropy dedicated to improving the health of Americans. The website has publications and research on health insurance coverage.
For More Information on Diabetes
American Diabetes Association (National Office)
1701 North Beauregard Street
Alexandria, VA 22311
Toll-Free Phone: 800-DIABETES (800-342-2383)
Website: www.diabetes.org
ADA’s website has a wealth of information on diabetes, living with diabetes, and community events. Call ADA’s hotline to receive free pamphlets or subscribe to the monthly magazine Diabetes Forecast. Visit ADA’s online bookstore for the latest books on diabetes.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Office of Communications and Public Liaison
NIDDK, NIH
Building 31, Room 9A06
31 Center Drive, MSC 2560
Bethesda, MD 20892-2560
Phone: 301-496-3583
Website: www.niddk.nih.gov
The NIDDK is an Institute of the National Institutes of Health. The website contains information for patients on diabetes care and research.
Diabetes Monitor
Website: www.diabetesmonitor.com
This in-depth website features information on medications and research and has a mentor section.