Form Dds-1 - Request For Developmental Disabilities Services (Page 5 of 5) in pdf

Form Dds-1 - Request For Developmental Disabilities Services Page 5

Request for Developmental Disabilities Services

06MP001E (DDS-1)

Return to DDSD office in the area where applicant resides.

DDSD Area I Office

DDSD Area III Office

729 Overland Trail

301 South Indian Meridian Road

Enid, OK 73703

Pauls Valley, OK 73075

Toll free: 1-800-522-1064

Toll free: 1-800-522-1086

Covers: Atoka, Beckham, Bryan,

DDSD Area I Office

Caddo, Carter, Choctaw, Cleveland,

4545 N. Lincoln Boulevard

Coal, Comanche, Cotton, Garvin,

Oklahoma City, OK 73105

Grady, Greer, Harmon, Haskell,

Toll free: 1-800-522-1064

Hughes, Jackson, Jefferson, Johnston,

Kiowa, Latimer, LeFlore, Love,

Covers: Alfalfa, Beaver, Blaine, Canadian,

Marshall, McClain, McCurtain, Murray,

Cimarron, Custer, Dewey, Ellis, Garfield,

Pittsburg, Pontotoc, Pottawatomie,

Grant, Harper, Kay, Kingfisher, Lincoln,

Pushmataha, Seminole, Stephens,

Logan, Major, Noble, Oklahoma, Payne,

Tillman, and Washita

Roger Mills, Texas, Woods, and Woodward

DDSD Area II Office

1427 East 8

Tulsa, OK 74120

Toll free: 1-800-522-1075

Covers: Adair, Cherokee, Craig, Creek,

Delaware, Mayes, McIntosh, Muskogee,

Nowata, Okfuskee, Okmulgee, Osage,

Ottawa, Pawnee, Rogers, Sequoyah, Tulsa,

Wagoner, and Washington

OKDHS revised 12-15-2006

Page 5 of 5

Form Dds-1 - Request For Developmental Disabilities Services Page 5