Supported Employment Program (SEP) and Vocational Rehabilitation/Work Activity Program (VR/WAP) Forms
The following forms are provided for use by DOR and service providers for Supported Employment (SE), Transitional Employment, Vocational Rehabilitation/Work Activity Program (VR/WAP), and general (non-SE) job coaching. Forms are described in RAM 31900.
SEP and VR/WAP English forms are also available in alternative formats.
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SEP AND VR/WAP FORMS
- DR371 Notice of Action in RTF
- DR372 Monthly Work Services Report in RTF
- DR373A Work Services Invoice Summary in RTF
- DR373B Work Services Invoice Detail in RTF
- DR373A&B Work Services Invoice Summary and Detail in MS Excel
- Supported Employment Forms
- DR381 Job Placement Parameters Sample Form in PDF
- DR382 Placement Services Progress Report in RTF
- DR383 Job Placement Information in RTF
- DR383A Group Job Coaching Referral (PDF)
- DR384 Monthly Job Coach Report in MS Excel
- DR384A Proposed Plan to Improve Performance in RTF
- DR385A Individual Invoice Summary (PDF)
- DR385B Individual Invoice Detail (Individual Placement) in RTF
- DR385AB Individual Invoice Summary and Detail in MS Excel
- DR385C Group Invoice Summary (PDF)
- DR385D Group Invoice Detail in RTF
- DR385E Group Job Coaching Invoice Detail in RTF
- DR385CDE Group Invoice Summary and Detail in MS Excel
- DR386 Invoice Discrepancy Notice Sample Form in PDF
- DR387 Notice of Transition to Extended Services Sample Form in PDF
of Developmental Services Habilitation SEP/WAP Work
Services Forms Page including:
- DS1964 - Supported Employment Group Billing and Attendance Form (Group Placement) completed by vendors.
- DS1968 - Vocational Rehabilitation Referral completed by regional centers.