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Forms

  • Referral Form

    View Form

  • Functional Limitations Sheet (for DRS Referrals)

    Download Form

  • 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.

    Download Form

  • 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.

    Download Form

  • 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.

    Download Form

  • 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.

    Download Form

  • 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.

    Download Form

  • Individualized Plan for Employment

    Stat of Illinois Department of Human Services – Division of Rehabilitation Services

    Download Form

  • STEP

    Learn more about the Secondary Transitional Experience Program.

    Download Brochure

QC Step  

Isaiah is a graduate of Rock Island High School. While in school, he received assistance with an application, interviewing skills, and a reference for a grocery store job.  Isaiah was hired and went from bagger to checker to grocery store clerk. He then continued to work for the company at a store in Dubuque, IA while earning his Bachelor’s Degree. Isaiah comments that STEP “has helped me a ton”.