Written Goal





WaivedAccepted


OngoingAchievedDropped



A. Self Advocacy/Self-empowermentB. CommunicationC. Mobility/TransportationD. Community-Based LivingE. EducationalF. VocationalG. Self-CareH. Information Access/TechnologyI. Personal Resource ManagementJ. Relocation from a Nursing Home or Institution to Community-Base Living Care/NutritionK. Community/Social ParticipationL. Other

___________________________________________ ___________

Other forms and information you will need:

Please print and complete:
State Goal Action Steps

Please Click here for Services and Goals

2950 S. Rainbow Blvd
Suite 220
Las Vegas, Nevada 89146

Voice/TDD/TTY: (702) 889-4216
Nevada Relay 711
Toll Free: (800) 870-7003
Fax: (702) 889-4574

Email: sncil@sncil.org