NEW REFERRAL FORM EFFECTIVE 6/26/2023

For assessments starting after 6/26/2023 we will need to use the VR5000 Referral for Provider Services form versus the 1836 Vocational Evaluation Referral.

Under additional Comments please include your referral questions:

SAMPLE REFERRAL QUESTIONS:

What is the present and future vocational potential of The Customer?

Does The Customer have the intellectual capability for a two year college program?

Does The Customer have the intellectual capability for a four year college program?

Does the personal situation or The Customer appear stable enough for employment?

What jobs are available in the local area that The Customer can perform?

Does the disability The Customer has constitute a severe vocational handicap?

Does The Customer have transferable skills which are usable in the current job market?

What behaviors did The Customer demonstrate during this assessment
What are the employment-related strengths and limitations of The Customer?
What disability related limitations make it difficult for The Customer to work?

Are there any behaviors that would affect vocational functioning for The Customer?

What seem to be reasons for The Customer to appear unmotivated toward work/rehabilitation?

Are there any medical or physical concerns for The Customer, not previously reported, that could affect vocational functioning?

Would the job interests reported by The Customer be feasible goals, why or why not?

Do you recommend a formal skill-training program for The Customer?

What general accommodations will enhance the opportunities for The Customer to work?

Does The Customer have the intellectual capability for formal vocational training?