Forms

  • DHS DRS Consent Form

    This is a Consent form to receive and participate in Vocational Rehabilitation Services from the Illinois Department of Human Services – Division of Rehabilitation Services (DHS-DRS). Signatures are required from both Student and their Parent/Legal Guardian.

  • DHS DRS Release Form

    This is a General release for medical records from a doctor, which will be used to determine Certification with DHS-DRS. Signatures are required from both Student and their Parent/Legal Guardian.

  • CHC Release of Information

    This is a release for medical records from Community Health Care’s various locations. Signatures are required from both Student and their Parent/Legal Guardian.

  • RYC Release of Information

    This is a release for medical records from Robert Young Center. Signatures are required from both Student and their Parent/Legal Guardian.

  • UIHC Release of Information

    This is a release for medical records from the University of Iowa Hospitals and Clinics. Signatures are required from both Student and their Parent/Legal Guardian.

  • Referral Form
QC Step  

Kimberly is a recent graduate of United Township High School. While in STEP classes, she participated in training sites, which ultimately resulted in paid work opportunities. Kimberly said, “Because I trained while in high school, they were able to see my skills, and I was able to get a part-time job my senior year. I was able to talk to people more and it helped me to be less shy.”