CRS 2.0 Service Report Forms (January 1, 2019 - December 31, 2023)
Entry Services
Level 1 - Entry Service 1
Orientation Provider Report
Orientation Attendance Sheet|
ACCES-VR Orientation (Consumer Survey)
Application Information Sheet
- Form: VR-AIS (Fill In)
- Form: Claim for Payment
Level 2 -Entry Service 2
Pre-Employment Transition Services (Pre-ETS)
Pre-ETS Counseling on Opportunities for Enrollment in Comprehensive Transition or Post-Secondary Educational Programs at Institutions of Higher Learning
Pre-ETS Job Exploration Counseling
Pre-ETS Instruction in Self-Advocacy
Pre-ETS Workplace Readiness Training to Develop Social Skills and Independent Living
Pre-ETS Work-Based Learning Development
Pre-ETS Worksite Based Trainer
Work-Based Learning Experience/Wage Reimbursement
Assessment Services
Career Exploration Assessment
Diagnostic Vocational Evaluation (DVE) / Community Based Situational Assessment (CBA)
Community Based Workplace Assessment (CBWA)
Standardized Testing / Specialized Evaluations
Job Preparation Services
Benefits Advisement
Self-Advocacy for Employment
Work Readiness 1 - Soft Skills Training
Work Readiness 1 - Soft Skills Training - Deaf Services
- Form: VR-125X126X (Fill In)
Work Readiness 2 - Skill Development
Work Readiness 3 - Skill Development and Work Experience
Job Retention - Tier 4 - (Corresponding to 630X)
Job Retention - Tier 4 - Deaf Services (Corresponding to 630X)
- Form: VR-932X/937X (Fill In)
Job Placement Services
Work Experience Development
Community Work Experience
Coaching Supports for Employment
Coaching Supports for Employment - Deaf Services
- Form: VR-959X/563X (Fill In)
Employment Customization
Direct Placement Intake - Tier 1
Job Seeking and Job Development - Tier 2
Job Seeking and Job Development - Tier 2 - Deaf Services
- Form: VR-929X/VR-935X (Fill In)
Job Placement - Tier 3
Job Placement - Tier 3 - Deaf Services
- Form: VR-931X/VR-936X (Fill In)
Job Retention - Tier 4
Job Retention - Tier 4 - Deaf Service
- Form: VR-932X/VR-937X (Fill In)
Quality Wage Incentive for Provider
Job Placement Monthly Placement Activity Report
Supported Employment Services
Supported Employment Intake
Core 1 SE Pre-Employment Assessment/Job Development
Core 2 SE Job Placement (Day 5)
Core 3 SE Job Placement (Day 45)
Core 4 SE Job Retention
SE Job Retention - Hours Per Week
Extended Supported Employment for Youth FTE
Extended Supported Employment FTE
- Form: Extended Supported Employment Roster (Fill In)
- Form: Claim for Payment
Employment Customization
Monthly Progress Report for Supported Employment
Assistive Technology / Rehabilitation Technology
Assistive Technology / Rehabilitation Technology Evaluation
Assistive Technology / Rehabilitation Technology Training
Driver Rehabilitation Services
Level I - Vendor Travel for Driver/Vehicle Evaluation or Training
Level II - Adaptive Driver Evaluation - Low Tech - Car or Van
Level II - Adaptive Driver Evaluation - High Tech - Car or Van
- Form: VR-133X/VR-134X (Fill In)
Level III - Adaptive Driver Training - Low Tech - Car or Van
Level III - Adaptive Driver Training - High Tech - Car or Van
- Form: VR-880X/881X (Fill In)
Adjunct Services
Coaching Supports - Not Job Placement Related
Communication Coaching Supports
Mobility Services
Transportation 1 - Facility Coordinated
Transportation 2 - Facility Provided