IDignity Orlando Client Service Request Form
Please still fill out this request form so that we have record of your client's needs and can appropriately prepare for our appointment with them.
Submitter Information
If your client is in:
Orange county: fill out the form below!
Osceola county:
idignity.osceola@idignity.org
Seminole county:
idignityseminole@idignity.org
This form is for new clients. If you have questions on your current case, please send an email to ccvolunteer@idignity.org.
Are you in need of services or requesting services for somebody else?
I'm in need of services
I'm requesting services for somebody else
Do you have a case manager or advocate that you want us to reach out to?
Yes
No
Advocate Contact Info
Agency Name
Advocate Name
First Name
Last Name
Advocate Email Address
Advocate Phone Number
Client Information
Client Name
First Name
Middle Name
Last Name
Last Name at Birth
Suffix
Date of Birth
MM/DD/YYYY
Which of these apply?
Born a US Citizen
Became a US Citizen
Legal Resident
Not a Legal Resident
Where were you born?
Please indicate state of birth if born in the US, or the country you were born in.
Documents You Need
Documents Needed
Florida Identification or Drivers License
Social Security Card
US Birth Certificate
Other Identification Documents
What other documents are you in need of?
IDignity does not assist with ordering birth certificates from outside of the US or passports.
Have you ever had a Florida ID before?
Yes
No
Unsure
Did your last FL ID / Drivers License have a gold star in the upper right hand corner?
Yes
No
Unsure
Documents You Have
When meeting with IDignity, please bring whatever you have from the list below.
Do you have an ID?
Yes - Valid Florida ID
Yes - Valid ID from another state
Yes - Expired ID
Yes - Photocopy or picture of an ID
No
Unsure
Do you have a original Birth Certificate or immigration document?
Yes - Original / Certified Copy
Yes - Photocopy
Yes - Unsure if it's original or not
No
Don't Know
You can often tell by checking for a raised seal on the document.
Do you have a Social Security Card?
Please select...
Yes - Original
Yes - Photocopy
No
Unsure
What other documents do you have?
Other original record(s)
Photocopy of other record(s)
None of the above
What other record(s)?
Address Information
If you are in need of ID, please also bring proof of address; please bring any of the below:
Proof of current private residence
Proof of residence at a shelter or transitional program
Proof of homelessness (letter from agency)
Letter of residency from person client is living with, as well as 2 proofs of that person's address
Other
What other address proof do you have?
Additional Comments
Follow-up
Client's Email Address
If none, please leave blank
Client's Phone Number
If none, please leave blank
What is the best way for IDignity to connect with you?
Case manager
Client
Please make sure contact information for either case manager or client is submitted, or we will not be able to contact you.
IDignity offers both in-person and phone intakes. Which do you prefer?
In person with an appointment (IDignity will reach out to schedule)
Over the phone (IDignity will reach out to schedule)
**Note: there are fewer appointments available for this option**
In person - client will walk up on a Tuesday or Thursday before 10am
Client's phone appointment has already been scheduled with their case manager
Please ensure you have enough phone minutes if you choose to do it over the phone; budget around 30-45 minutes.
Date of pre-scheduled appointment
IDignity is taking every precaution to provide a safe environment for our clients. Based on the results of this survey, IDignity will either reach out to you or the client to schedule a virtual or in-person interview. Thank you for your understanding.
IDignity - Contact Info