INLAND REGIONAL CENTER ...valuing independence, inclusion and empowerment P.O. Box 19037, San Bernardino, CA 92423 Telephone: (909) 890-3000 Fax: (909) 890-3001 Intake Service Review For Individuals OVER 3 years of age Do you/applicant live in Riverside or San Bernardino counties? Yes No If you do not live in the Inland Empire (San Bernardino/Riverside County) areas, you need to apply for services at the Regional Center that serves the area in which you live. Go to www.dds.ca.gov and you will find a related links on the left side column. For a list of of Reginonal Centers in California, click California Regional Centers list. Do you/applicant have a developmental disability that originated prior to the age of 18, continues or is expected to continue indefinitely and constitutes a substantial disability? Yes No Developmental Disability includes: (1) Epilepsy: Significant impairments of excessive and/or abnormal brain cell activity. (2) Cerebral Palsy: Significant impairments of movement, muscle tone or posture. (3) Autism (Autism Spectrum Disorder): Significant impairments in social interaction and communication, along with repetitive and stereotyped patterns of behavior. (4) Intellectual Disability: IQ scores that are near or below 70 and significant handicaps in adaptive functioning. (5) 5th Category-a disabling condition found to be closely related to Intellectual Disability or requiring treatment similar to that required for an individual with an Intellectual Disability that requires comparable treatment. Substantial Disability means a person who experiences significant limitations in three or more of the following areas: self-care, language, learning, mobility, self-direction, capacity for independent living or economic self-sufficiency. (Please note that disabling conditions that are only physical or psychiatric in nature, or exclusively a learning disability, are not eligible for services under the Lanterman Act.)