Contact Us

Central Office:	Empowerment Options P.O. Box 26188 Austin, TX 78755 Tel: 512/338-4493 Fax: 512/338-1555
Austin Office:	Empowerment Options P.O. Box 26188 Austin, TX 78755 Tel: 512/338-4493 Fax: 512/338-1555
Conroe Office:	Empowerment Options P.O. Box 1710 Conroe, TX 77305 Tel: 936/756-6350 Toll-free: 877/301-7571 Fax: 936/756-6351
Houston Office:	Empowerment Options 3727 Greenbriar Suite 100 Stafford, TX 77477 Tel: 281/980-0412 Toll-free: 800/324-2689 Fax: 281-980-0486
Waco Office:	Empowerment Options P.O. Box 2570 Temple, TX 76503 Tel: 254/742-1932 Toll-free: 877/514-1932 Fax: 254/742-1969

If you would like us to contact you regarding possible placement with Empowerment Options, please complete this form.

Your Name:

Telephone #: 

E-mail: 

Which type of service(s) are you interested in?

In-Home Support Foster Care 24-Hour Residential Services Vocation/Day Habilitation CLASS Case Management Respite Care

Which county would be acceptable for your family member/friend to receive services in?

Bastrop Bell Bosque Coryell Harris Lee Liberty McLennan Montgomery Travis Walker Williamson

Is your family member/friend currently receiving services in any of the following programs?

ICF-MR HCS TxHmL

Is your family member/friend receiving Social Security, SSI or Medicaid?

Yes No

Does your family member/friend have a mental retardation or related condition diagnosis?
Yes No

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