Get Dr383a

This guide provides step-by-step instructions on completing the Dr383a form online for supported employment group job coaching referrals and authorizations. By following these instructions, users can ensure that all necessary information is accurately provided.

Follow the steps to successfully complete the Dr383a form online.

1. First, click the ‘Get Form’ button to access the Dr383a form and open it in your preferred online editor.
2. In the first section, enter the name and address of the service provider and the work site where the job coaching will occur. Provide the employer's phone number for further contact.
3. Specify the job coach rate, indicating the hourly rate for the job coaching services.
4. Fill in the date fields, including the date of the application, the consumer's name, and their unique consumer identification number (UCI).
5. Record the details of the DOR Counselor and the relevant DOR District responsible for the consumer.
6. Indicate the start and end dates for the job coaching service, alongside the planned stabilization date.
7. Provide information about work hours, specifying the estimated work hours per week and per month.
8. Complete the supervisor's name and the maximum Lunch Break Support hours allowed per month.
9. Ensure you accurately detail the maximum allocated job coach hours per month, which should include the Lunch Break Support hours.
10. After filling out all sections, review the entire form for accuracy and completeness. You can then choose to save changes, download, print, or share the form as needed.

Start completing your Dr383a form online today!