Get Dr222

Completing the Dr222 form is essential for accessing vocational rehabilitation services in California. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to successfully complete the Dr222 form.

1. Press the ‘Get Form’ button to obtain the Dr222 form and open it in your preferred editor.
2. Begin by filling out your personal information. This includes your last name, first name, middle initial, and any other names you have used. Ensure the accuracy of this information for proper identification.
3. Provide your street address, mailing address (if different), city, zip code, and the county where you reside. This helps the department to contact you effectively.
4. Enter your contact details, including your phone number, cell phone number, and email address. Make sure these are up-to-date to avoid communication delays.
5. Indicate your date of birth and age. This information is necessary for eligibility verification.
6. In the section regarding your physical or mental impairment, provide a description that constitutes or results in a substantial impediment to employment. Be as detailed as possible to ensure appropriate support.
7. Next, answer the question on how the Department can assist you. This can include specific services you are seeking.
8. Provide information about who referred you to the Department of Rehabilitation, including their full name and your relationship.
9. Authorize the release of information to prospective employers by selecting 'yes' or 'no.' Initial your consent to ensure understanding of the implications of this release.
10. Acknowledge receipt of orientation materials by providing your initials. This indicates your understanding of the key concepts discussed with your counselor.
11. Select your status regarding employment eligibility by checking the appropriate box. If you are an alien, you must provide your Alien Number or Admission Number, along with the expiration date of your employment authorization, if applicable.
12. Finally, sign and date the application. If you are a minor, a parent or guardian's signature is also required.
13. Once all sections are completed, you can save your changes, download the form, print it, or share it as needed.

Complete your Dr222 form online today to access the vocational rehabilitation services you need.