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CONFIDENTIAL REFERRAL FORM Name Address City State Telephone Age Zip code Social Security DOB Highest Grade of School Completed What is your Disability Are you physically able to come to this office Yes NO Have you ever applied to DVRS before If Yes where When Do you speak English Referred by Completed forms can be accepted by any local DVRS location click link below or faxed to Central Office at 609 292-8347.

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How to fill out the Dvrs Referral Form online

Filling out the Dvrs Referral Form is an essential step in accessing the services provided by the Division of Vocational Rehabilitation Services. This guide will walk you through the process step-by-step, ensuring that you complete the form correctly and efficiently.

Follow the steps to fill out the Dvrs Referral Form online.

  1. Press the ‘Get Form’ button to retrieve the Dvrs Referral Form and open it in your preferred editor.
  2. Begin filling in your details. Start with your name by entering it in the designated field. Ensure that you spell your name correctly as it appears on your identification documents.
  3. Next, provide the date of completion. Enter the current date in the space provided.
  4. Fill in your complete address, including street, city, state, and zip code. This is important for correspondence purposes.
  5. Input your telephone number, age, and social security number in the respective fields. Ensure accuracy; it is crucial for your application.
  6. Indicate your sex and date of birth by filling in the respective fields.
  7. Specify the highest grade of school you have completed. Providing this information helps in understanding your educational background.
  8. Describe your disability in the provided space. Be as specific as possible to assist in appropriate service allocation.
  9. Answer whether you are physically able to visit the office by selecting Yes or No.
  10. Indicate if you have ever applied to DVRS before. If yes, provide the location and date of your previous application.
  11. State your proficiency in English by answering Yes or No.
  12. Fill out the referral source's information, including their name, address, and telephone number.
  13. Review the entire form to ensure all information is accurate and complete. Once satisfied, you can save your changes, download, print, or share the completed form as needed.

Complete the Dvrs Referral Form online today to access vital services.

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Division of Vocational Rehabilitation (DVR)

The New Jersey Division of Vocational Rehabilitation Services (DVRS) works with students who have disabilities, including those with a 504 Plan or other documented disability that impedes a student's ability to succeed in competitive employment.

DVR is required to verify disability status and identify functional limitations. In other words, a person must have a disability that interferes with the ability to work and must need vocational rehabilitation services to obtain or maintain employment.

Overview. Under the FECA, referrals are made for vocational rehabilitation services if the Injured Worker (IW) is eligible for, and can benefit from, such services.

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