Dear Vocational Rehabilitation Applicant,
It was my pleasure to visit with you today regarding the services at the Iowa Department for the Blind. Enclosed in this packet, there are several documents requiring your signature. Sticky notes have been placed just below the signature lines.
To-Do List:
Please sign the following forms right above the sticky notes:
Application Release for Services (Department Copy)
Release of Information (there may be more than one)
Voter Registration Form
Please return the signed documents in the self-addressed stamped envelope
We will need a copy of your most recent medical eye examination report to assist in determining your eligibility for services. Information required on this medical report is:
Your best corrected visual acuity score in the better eye
Visual Field results (if test was performed)
Your visual diagnosis and prognosis
If possible, please fax the eye report to our office at 515-242-5781, ATTN: VR Program
The two brochures in the packet are for your information and will be reviewed with you by your VR counselor after we receive your application for services. These brochures include information about your Rights and Responsibilities as a VR client and about the Iowa Client Assistance Program.
Please feel free to contact me with any questions at 515-901-8621 or ann.fremont@blind.state.ia.us
The Iowa Department for the Blind is looking forward to assisting you.
Sincerely
AnnSignature
Ann Fremont, Intake Specialist
Iowa Department for the Blind
1-800-362-2587 toll free, option 1
1-515-901-8621 direct dial
1-515-242-5781 fax
ann.fremont@blind.state.ia.us