Olmstead Advisory Committee Application

 

4

Consumer Advocacy

Developmental Disabilities

 

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What would you like to do?

What would you like to do?

What you need to know

What you need to know

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​​​​​​​​​Per Neb Rev Statute 81-6122​ the CEO of DHHS shall appoint and convene a stakeholder advisory committee to assist in the review of and advise states Olmstead Plan. More information can be found at the link provided.​

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Questions:

Please correct the errors in filling the form.

Are you 19 years old or over?

Yes
No

Do you identify as a person with a disability?

Yes
No

First Name

Last Name

Phone Number

Phone Type Home Mobile Work

Email

Confirm Email

What county do you live in? Adams Antelope Arthur Banner Blaine Boone Box Butte Boyd Brown Buffalo Burt Butler Cass Cedar Chase Cherry Cheyenne Clay Colfax Cuming Custer Dakota Dawes Dawson Deuel Dixon Dodge Douglas Dundy Fillmore Franklin Frontier Furnas Gage Garden Garfield Gosper Grant Greeley Hall Hamilton Harlan Hayes Hitchcock Holt Hooker Howard Jefferson Johnson Kearney Keith Keya Paha Kimball Knox Lancaster Lincoln Logan Loup Madison McPherson Merrick Morrill Nance Nemaha Nuckolls Otoe Pawnee Perkins Phelps Pierce Platte Polk Red Willow Richardson Rock Saline Sarpy Saunders Scotts Bluff Seward Sheridan Sherman Sioux Stanton Thayer Thomas Thurston Valley Washington Wayne Webster Wheeler York

Will you need accessibility accommodations? No Yes

If yes, what accommodations will you need?

What organization or group do you represent?

Thank you for your submission. Your submission will be reviewed and you will receive a message from a member of our team. If you have any questions you may contact us at DHHS.NEOlmstead@nebraska.gov

Return to the Olmstead Plan page

Your submission did not go through please contact program manager and report the time of failure.

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