Required fields are marked with an asterisk (*).
This VBHC VOC Pilot Intake Report must be completed with the client and at the same time as completing the TAC Vocational Services Initial Assessment Form.
This VBHC VOC Pilot Completion Report must be completed after the client has returned to work (minimum 7-days after the client has returned to work and maximum of 28-days after the client has returned to work).
In the case the RTW work outcome is not achieved or the client does not proceed, please complete the form at closure.
The Completion Report can be completed with the client either F2F or video conference or via telephone.
[PLEASE READ THIS ALOUD TO CLIENTS PRIOR TO COMPLETING THIS FORM]