Get Usor Application - Usor Utah

Filling out the USOR Application is an important step in accessing vocational rehabilitation services in Utah. This guide will provide you with clear and supportive instructions to help you complete the application accurately and effectively online.

Follow the steps to successfully complete the USOR Application online.

1. Press the ‘Get Form’ button to obtain the application form and open it in your preferred editor.
2. Begin by filling in your social security number and the case number, if applicable, in the designated fields.
3. Enter your legal name, including your last name, first name, and initial. Ensure accuracy as proof of identity is required.
4. Provide other names you have used if applicable.
5. Complete your address, including city, state, zip code, and county to ensure that you can be reached.
6. Input your telephone number and an alternate phone number to facilitate communication.
7. Fill in your email address to provide an electronic means of communication.
8. Select your gender by checking the appropriate box.
9. Input your birthdate in the provided format (MM/DD/YY).
10. Describe your physical or mental disability, including when it occurred and what caused it.
11. Explain how your disability affects your ability to work and outline any limitations.
12. Detail what assistance you require to secure employment or maintain your job.
13. List any medical professionals you have worked with, including their names, addresses, phone numbers, and treatment dates.
14. Report any medications you are currently taking.
15. Indicate your current medical insurance coverage by checking applicable options.
16. List any special technology or equipment you currently use or need for work.
17. Outline your work history, including positions held, hours worked per week, weekly income, dates of employment, and reasons for ending employment.
18. Indicate the highest grade you completed in school and your current educational status.
19. Provide details about any background issues that may affect your employability.
20. Confirm your citizenship status and provide information about your visa if applicable.
21. Disclose any prior employment with vocational rehabilitation services.
22. List any other agencies from which you are receiving services.
23. Describe your current living arrangement by checking the applicable option.
24. State your main source of financial support and indicate if you are receiving public income support, providing amounts where required.
25. Identify your race and ethnicity by checking the appropriate boxes.
26. Indicate your marital status by selecting the correct option.
27. If applicable, provide details about your military service.
28. Provide contact information for someone who would know your address in case you move.
29. Review the confidentiality and eligibility information carefully before signing the application.
30. Sign the application and date it. If you are a minor, have a parent sign it as well.
31. After completing the application, you can save your changes, download, print, or share the form as needed.

Complete your application online today to access Utah's vocational rehabilitation services.