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Employment Support Services Contract and Forms

Employment Support Services

OK Library for the Blind and Physically Handicapped
300 N.E. 18th Street
Oklahoma City, OK 73105

Office: (405) 522-2123
Toll Free: (800) 523-0288
Fax: (405) 522-2139

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000c Sample FY 2025 Contracts.zip

Download: FY25 (Final-Sample) Contracts.zip

000f FY 2023 All Forms (Official) (ZIP File) (132 MB)

Download: 000f FY 2023 All Forms (Official).zip

000fc All FY 2024 All Contracts All Forms Checklists (Official) (PDF)

Download: All FY 2024 All Contracts All Forms Checklists into single PDF file

003c FY 2023 Employment Support Services Contract (Sample)

Download: FY24 Employment Support Services Contract (Final-Sample) 2023-06-05.docx

003f FY 2023 ESS Forms (Official)

Download: 003f FY 2023 ESS Forms (Official).zip

003fc FY 2023 [ESS-0] Contract Forms Checklists ZIP File

Download: 003fc FY 2023 [ESS-0] Contract Forms Checklists (Rev 2022-09-14).zip

ESS-C-117 Travel Log and Invoice (Rev. 2024-03-06)

Download: ESS-C-117 Travel Log and Invoice (Rev 2024-3-06).pdf

ESS-C-133 DRS Counselor Monthly Update Form (Rev. 2021-08-11)

Download: ESS-C-133 DRS Counselor Monthly Update Form (Rev. 2021-08-11)

ESS-C-181 Termination & Re-Placement Report

Download: ESS-C-181 Termination & Re-Placement Report (Rev 2023-11-27)

ESS-C-345 ESS Authorization Request and Billing Form (Rev. 2023-08-09)

Download: ESS-C-345 ESS Authorization Request & Invoice (Rev 2023-08-09)

ESS-C-349 ESS Assessment Referral (Rev. 2023-12-08)

Download: ESS-C-349 ESS Assessment Referral (Rev 2023-12-08)

ESS-C-353-1 ESS Assessment - Cognitive Assessment

Download: ESS-C-353-1 — Cognitive Assessment.pdf

ESS-C-353-2 ESS Assessment - Communication Assessment

Download: PDF icon ESS-C-353-2 — Communication Assessment.pdf

ESS-C-353-3 ESS Assessment - Computer Technology Assessment

Download: ESS-C-353-3 — Computer Technology Assessment.pdf

ESS-C-353-4 ESS Assessment - Daily Living Assessment

Download: ESS-C-353-4 — Daily Living Assessment.pdf

ESS-C-353-5 ESS Assessment - Housing Assessment

Download: ESS-C-353-5 — Housing Assessment.pdf

ESS-C-353-6 ESS Assessment - Mobility Assessment (Rev 2022-08-24)

Download: ESS-C-353-6 Mobility Assessment (Rev. 2022-08-24)

ESS-C-353-7 ESS Assessment - Work/Training Tolerance Assessment

Download: ESS-C-353-7 — Work-Training Tolerance Assessment.pdf

ESS-C-353-8 ESS Assessment - Transportation Assessment

Download: ESS-C-353-8 — Transportation Assessment.pdf

ESS-C-353-9 ESS Assessment Summary (Rev. 2022-03-09)

Download: ESS-C-353-9 ESS Assessment Summary (Rev 2022-03-09).pdf

ESS-C-357 ESS Training Support Plan (Rev. 2022-08-23)

Download: ESS-C-357 ESS Training Support Plan (Rev. 2022-08-23)

ESS-C-358n Copy of e-mail to DRS Counselor of ESS Training Support Plan (Rev. 2022-08-16)

Download: ESS-C-358n Copy of email to DRS Counselor of ESS Training Support Plan (Rev 2022-08-16)

ESS-C-361n DRS Counselor Approval ESS Training Support Plan (Rev. 2022-08-12)

Download: ESS-C-361n DRS Counselor Approval ESS Training Support Plan (Rev 2022-08-12)

ESS-C-365 ESS Training Support Summary (Rev. 2022-08-30)

Download: ESS-C-365 ESS Training Support Summary

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