If you or someone you know would like to apply for vocational rehabilitation services, please complete and submit the form below with as much information as you can. This is not an application for services. However, this information will help us to ensure the most appropriate vocational rehabilitation staff person contacts you about how we may be able to assist you.

*Written Notice of Beneficiary Protections-Because this program is supported in whole or in part by financial assistance from the U.S. Department of Education, we are required to provide you with information regarding your beneficiary protections before you enroll in the program or receive services from the program. In the instance of a circumstance where it is impracticable to provide this written notice of beneficiary protections before the service is provided, this notice must be given to you at the earliest available opportunity.

Please click on the document to read the full listing of beneficiary protections and the designated DVR contact person to direct any questions.