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SOAR Referral Form

Refer an adult who may be eligible for SSI/SSDI benefits assistance through the SOAR model. PDS SOAR staff will review the referral and follow up with the person listed below. Do not use this form for emergencies — call 911 or 988 for immediate help.

Your answers are sent privately to PDS staff and are never shown publicly.

Person Being Referred

Person Making This Referral

Leave blank if self-referring

Disability, current benefits, urgency, or anything helpful for our SOAR team