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Social Security Online		 Disability Programs
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Disability Report Form Guide (Adults)
Disability Report Form Guide (Adults)

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Section 1- Information About the Disabled Person

A. Name
B. Social Security Number
C. Daytime Telephone Number
D. Name of a Friend or Relative
E. Height
F. Weight
G. Medical Assistance Card
H., I., J. Can You Speak, Read, Write, and Understand English?

MORE INFORMATION:
Publications in Non-English Languages
Interpreter Services

Learn More About Disability Benefits and How We Decide If You Are Disabled

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Last reviewed or modified Tuesday Apr 08, 2008
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