Admission Inquiries

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Thank you for your interest in receiving services at Merrick, Inc. To start the application process, please complete and submit the online admission inquiry form.

When submitting an inquiry, all applicants must upload a completed application for admission form. For your convenience, we have made the application for admission form available to download below. The form includes general questions about the individual to be served, their desired service area, diagnosis, funding type, vocational history, contact information for their support team, and more.

In addition to the application form, applicants will be required to upload the following documents.

• Coordinated Support Plan (CSP)
• Coordinated Service and Support Plan (CSSP)
• Psychological Assessment/IEP

Please have these documents readily available when submitting your inquiry. Lastly, please note that the prospective client must have a DSM11 diagnosis documented by a licensed psychologist, psychiatrist, physician, or other qualified professional.

If you have additional questions regarding intake, referrals, or transition, please contact the program director corresponding to your program of interest. If you are looking to receive Independent Employment Support Services, please complete the application, and someone from our I-team will contact you regarding your request.

Admission Inquiry Form