CRS 2.0 Service Report Forms (January 1, 2019 - December 31, 2023)
Entry Services
Level 1 - Entry Service 1
Orientation Provider Report
- Form: VR-O (VR-O Fill In)
Orientation Attendance Sheet|
- Form: VR-OA (VR-OA Fill In)
ACCES-VR Orientation (Consumer Survey)
- Form: VR-OS (VR-OS Fill In)
Application Information Sheet
- Form: VR-AIS (VR-AIS Fill In)
- Form: Claim for Payment
Level 2 -Entry Service 2
- Form: VR-118X (VR-118X Fill In)
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
- Form: VR-121X (VR-121X Fill In)
Pre-ETS Job Exploration Counseling
- Form: VR-122X (VR-122X Fill In)
Pre-ETS Instruction in Self-Advocacy
- Form: VR-124X (VR-124X Fill In)
Pre-ETS Workplace Readiness Training to Develop Social Skills and Independent Living
- Form: VR-127X (VR-127X Fill In)
Pre-ETS Work-Based Learning Development
- Form: VR-557X (VR-557X Fill In)
Pre-ETS Worksite Based Trainer
- Form: VR-964X (VR-964X Fill In)
Work-Based Learning Experience/Wage Reimbursement
- Form: VR-963X (VR-963X Fill In)
Assessment Services
Career Exploration Assessment
- Form: VR-120X (VR-120X Fill In)
Diagnostic Vocational Evaluation (DVE) / Community Based Situational Assessment (CBA)
- Form: VR-110X (VR-110X Fill In)
Community Based Workplace Assessment (CBWA)
- Form: VR-112X (VR-112X Fill In)
Standardized Testing / Specialized Evaluations
- Form: VR-100X (VR-100X Fill In)
Job Preparation Services
Benefits Advisement
- Form: VR-175X (VR-175X Fill In)
Self-Advocacy for Employment
- Form: VR-123X (VR-123X Fill In)
Work Readiness 1 - Soft Skills Training
Work Readiness 1 - Soft Skills Training - Deaf Services
- Form: VR-125X/126X (VR-125X/126X Fill In)
Work Readiness 2 - Skill Development
- Form: VR-625X (VR-625X Fill In)
Work Readiness 3 - Skill Development and Work Experience
- Form: VR-630X (VR-630X Fill In)
Job Retention - Tier 4 - (Corresponding to 630X)
Job Retention - Tier 4 - Deaf Services (Corresponding to 630X)
- Form: VR-932X/937X (VR-932X/937X Fill In)
Job Placement Services
Work Experience Development
- Form: VR-559X (VR-559X Fill In)
Community Work Experience
- Form: VR-958X (VR-958X Fill In)
Coaching Supports for Employment
Coaching Supports for Employment - Deaf Services
- Form: VR-959X/563X (VR-959X/563X Fill In)
Employment Customization
- Form: VR-510X (VR-510X Fill In)
Direct Placement Intake - Tier 1
- Form: VR-921X (VR-921X Fill In)
Job Seeking and Job Development - Tier 2
Job Seeking and Job Development - Tier 2 - Deaf Services
- Form: VR-929X/VR-935X (VR-929X/935X Fill In)
Job Placement - Tier 3
Job Placement - Tier 3 - Deaf Services
- Form: VR-931X/VR-936X (VR-931X/936X Fill In)
Job Retention - Tier 4
Job Retention - Tier 4 - Deaf Service
- Form: VR-932X/VR-937X (VR-932X/937X Fill In)
Quality Wage Incentive for Provider
- Form: VR-933X (VR-933X Fill In)
Job Placement Monthly Placement Activity Report
- Form: VR-MPAR (VR-MPAR Fill In)
Supported Employment Services
Supported Employment Intake
- Form: VR-571X (VR-571X Fill In)
Core 1 SE Pre-Employment Assessment/Job Development
- Form: VR-572X (VR-572X Fill In)
Core 2 SE Job Placement (Day 5)
- Form: VR-573X (VR-573X Fill In)
Core 3 SE Job Placement (Day 45)
- Form: VR-574X (VR-574X Fill In)
Core 4 SE Job Retention
- Form: VR-575X (VR-575X Fill In)
SE Job Retention - Hours Per Week
- Form: VR-576X (VR-576X Fill In)
Extended Supported Employment for Youth FTE
- Form: VR-582X (VR-582X Fill In)
Extended Supported Employment FTE
Employment Customization
- Form: VR-510X (VR-510X Fill In)
Monthly Progress Report for Supported Employment
- Form: VR-MPSE (VR-MPSE Fill In)
Assistive Technology / Rehabilitation Technology
Assistive Technology / Rehabilitation Technology Evaluation
- Form: VR-165X (VR-165X Fill In)
Assistive Technology / Rehabilitation Technology Training
- Form: VR-167X (VR-167X Fill In)
Driver Rehabilitation Services
Level I - Vendor Travel for Driver/Vehicle Evaluation or Training
- Form: VR-142X (VR-142X Fill In)
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 (VR-133X/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 (VR-880X/881X Fill In)
Adjunct Services
Coaching Supports - Not Job Placement Related
- Form: VR-790X (VR-790X Fill In)
Communication Coaching Supports
- Form: VR-792X (VR-792X Fill In)
Mobility Services
- Form: VR-M (VR-M Fill In)
Transportation 1 - Facility Coordinated
- Form: VR-V (VR-V Fill In)
Transportation 2 - Facility Provided
- Form: VR-T (VR-T Fill In)
Performance Review (for ACCES-VR Staff Only)
Performance Review
- Form: VR-REV (VR-REV Fill In)