Revised Application for VR Services – VR-04

In order to comply with RSA’s new data reporting requirement, a workgroup was formed in Central Office. Some changes in data collection are necessary. Specifically, the group believed revising the Application form (VR-04) would assist to capture the data as required.

Therefore, the Application form (VR-04) has been revised. The primary change is the collection of additional address information. Behind the scenes, the CaMS system will now maintain “zip code at application.” Other changes include adjustments in spacing.

The VR-04 will be replaced on the Z drive and posted on ACCES-VR’s website. It is currently available in English. For those who require Spanish, Mandarin Chinese, Haitian Creole or Russian, please use the current version until reproduced in alternate languages.

Please begin using the revised Application on July 1, 2014. If you have questions, please consult with your District Office Manager. 

Date Issued: June 26, 2014