Assessment:

Expectation of VR services:

Current situation (living/working/school/etc)

Medical, psychological, and disability needs:

Employment needs:

Educational background:

Social/recreational involvement:

Barriers identified in assessment (eligibility aid):

Intervention

(completed application and health assessment, signed ROIs, offered client to register to vote, reviewed ICAP, and rights and responsibilities):

Plan:

Counselor next steps (contact providers, complete eligibility, etc):

Client next steps (review possible employers in community, sign up at workforce, locate and send resume, etc):

Date of next meeting (no more than 30 days):