Get Sample Case Review Form - Vr4 Hearing Loss - Vr4hearingloss

Filling out the Sample Case Review Form for VR4 Hearing Loss can seem daunting, but this guide is designed to help you navigate the process step-by-step. Whether you are a counselor or a user, completing the form accurately is crucial for ensuring the right services are provided.

Follow the steps to successfully fill out the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by indicating your role by checking the appropriate box: 'Counselor for the Deaf', 'Counselor for Hard of Hearing & Late Deafened', or 'General Counselor'. Ensure you select exactly one option.
3. Provide the consumer’s name in the designated field, ensuring spelling is accurate to avoid future issues.
4. Enter the RSA Disability Code. This code is key to processing the case.
5. Indicate whether the consumer is coded as severely disabled and if they are Most Severely Disabled (MSD) by checking 'Y' for yes or 'N' for no.
6. Confirm that the severity is coded correctly by checking 'Y' or 'N'.
7. Fill in the consumer's age at application in the appropriate space provided.
8. Select the employment status at application by choosing either 'Not employed', 'Employed', or 'Homemaker'.
9. Specify the consumer's mode of communication by checking 'Voice', 'Sign', or 'Written'. If not assessed and documented, please select that option.
10. Describe how the counselor communicated with the consumer by selecting options such as 'Lipreading', 'ALD', 'Writing/Typing', 'Interpreter', or 'Not documented'.
11. Indicate if the comprehensive assessment is complete by checking 'Y' for yes or 'N' for no. If no, note what is missing.
12. Answer whether functional limitations and employment impediments are specific to the current or anticipated employment situation.
13. Determine if a hearing aid is the only service provided. If no, indicate other services offered and if the consumer is a first-time user.
14. If a hearing aid was provided, answer questions regarding expectations, counseling on use, care, and rehabilitation.
15. Explore whether assistive listening devices and other job accommodations were considered.
16. Assess if personal adjustment problems, like stress or communication issues, were explored.
17. Note the number of months the case has been open.
18. Indicate the status at closure: Employed, Homemaker, or Other, and provide details if applicable.
19. Record the number of consumer contacts made after the Individualized Plan for Employment (IPE) aside from letters.
20. Finally, determine whether post-employment services were anticipated in the closure IPE and specify what services were expected.
21. Review all sections for accuracy, then save changes, download, print, or share the completed form as needed.

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