The Arizona Department of Economic Security/ Division of Developmental Disabilities provides needed supports to people who meet the following eligibility requirements.

  • Is a resident of the state of Arizona
  • Voluntarily applies
  • Is at risk of having a developmental disability (up to age 6) or
  • For people over the age of 6 years, has a diagnosis of
    • epilepsy,
    • cerebral palsy,
    • cognitive disability or
    • autism
    • Down syndrome
  • The disability occurred prior to the age of 18 and
  • Has substantial functional limitations in 3 of the 7 major life areas.

Refer a Family

Do you or someone you know need our assistance?

Family Referral Form

Choose a language to translate this form.


Instead of using this form, please email the referral directly to pfcreferrals@encirclefamilies.org so we can support the family as quickly and smoothly as possible. Thank you for referring families to our PFC program!
Professional Information






Family Information


















By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. You will receive no more than two attempts to reach you via SMS text message. Message & data rates may apply. You can reply STOP at any time to opt-out of further messaging. For help, please call 602-242-4366.
Optional Information
This information helps us ensure that we are serving our entire community. This section is optional and has no impact on the availability of services from Encircle Families. Our services are always available at no cost to all Arizona families.



Examples include free school lunches, Income-based AHCCCS, SNAP.


Contact Information