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Apply for Services

Thank you for your interest in applying for services at Exceptional Persons, Inc. This admission information is for the following EPI services:

  • Residential
  • Employment
  • Day Habilitation
  • Services for Children with Disabilities

Please fill out and submit the following form to proceed.

Person Making Referral

Applicant Information

Funding

Current Provider or Primary Caregiver


Please check all that may be of interest to the person requesting EPI services:

PLEASE NOTE: Additional information is necessary to screen a person for program eligibility. An application will be considered complete when the following documentation is received:

  1. Social History
  2. Medical History / Reports
  3. Psychological Evaluation (including Full Scale IQ)
  4. Psychiatric Evaluation
  5. Major Incident Reports/Incident History
  6. Current Case Management Plan / Individual Program /Individual Educational Plan
  7. Assessments
  8. List of providers of other services and or past services

Additional information can be sent the following ways:

Email: intakes@episervice.org
Fax: (319) 232-0453
Mail: Intakes, Exceptional Persons, Inc., P.O. Box 4090, Waterloo, IA 50704