Support Services for Employment Contract and Forms
Job Seekers Pages
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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Contract Specific Forms
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Daily Living Assessment - ESS-C-353-4
Daily living assessment Rev 2020-02-19
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ESS Assessment Referral - ESS-C-353-0
ESS Assessment Referral to CRP - Rev 2022-08-24
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Transportation Assessment - ESS-C-353-8
Assessment to assist in determining transportation needs for employment
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Cognitive Assessment - ESS-C-353-1
Cognitive Assessment Rev 2020-02-19
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Communication Assessment - ESS-C-353-2
Rev. 2020-02-19
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Computer Technology Assessment - ESS-C-353-3
Assessment to determine level of computer literacy
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ESS Assessment Summary - ESS-C-353-9
Rev. 2022-03-09
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ESS Training Support Plan - ESS-C-357
ESS Training Support Plan - Rev 2023-01-06
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ESS Training Support Plan - ESS-C-357
ESS Training Support Plan - Rev 2022-08-23
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Housing Assessment - ESS-C-353-5
Rev. 2022-02-11
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Instructions for ESS Training Support Plan - ESS-C-358n
Email to DRS Counselor prior to beginning services. If not answer in 5 days, begin providing services. If answer received, save and submit copy with documentation for payment.
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Mobility Assessment - ESS-C-353-6
Mobility Assessment for employment Rev 2022-08-24
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SSE Training Support Summary - ESS-C-365
Rev 2025-01-21
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Tolerance Assessment - ESS-C-353-7
Work and Training Tolerance Assessment - Rev 2020-02-19
FY2025 General Forms
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Assessment Milestone Report - ESS-C-310
Rev 2023-01-05
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Authorization Request and Invoice - ESS-C-801
Rev 2024-08-01
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Contractor Staff and Training Tracking Form - ESS-A-005
Contractor Staff and Training Form. Rev. 2024-12-19
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Customized Assessment(s) (ERC) - ESS-C-305n
Rev 2022-09-08
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DRS Counselor Monthly Update Form - ESS-C-133
Rev 2024-11-20
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DRS Counselor Response to ESS-C-278 Plan for Assessment ESS-C-278n
Rev 2022-07-08
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Educational Experience Report (when in training) - ESS-C-710
Rev 2022-08-31
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EM Record of Hours Worked for EM 90-Day Milestones-Services - ESS-C-225 (4)
(Rev 2022-09-22)
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Employee Performance Report - ESS-C-810
Rev 2022-09-02
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Employee Satisfaction Survey - ESS-C-249
Rev 2021-09-09
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Employment Outcome Report - ESS-C-266
Employment Outcome Report. Rev 2024-11-22
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Employment Verification Form
Rev 2022-09-21
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HC ST Record of Hours Worked for EM 16 Week Milestones - ESS-C-225 (2)
Rev 2022-09-22
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Incentive Payment Request Form - ESS-A-020
Rev 2023-04-18
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Incentive Payment Request Form - ESS-A-020
Incentive Payment Request Form. Rev 2025-01-21
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Instructions for ESS-C-145n
Rev. 2022-08-12
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Instructions for ESS-C-149n
Rev. 2022-08-12
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Instructions for ESS-C-153n
Rev. 2022-08-12
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Instructions for ESS-C-197n
Rev. 2022-08-12
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Instructions for ESS-C-213n
Rev. 2020-09-02
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Instructions for ESS-C-237n
Rev. 2022-08-12
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Instructions for ESS-C-285n
Rev. 2022-08-12
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Instructions for ESS-C-289n
Rev. 2020-02-25
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Instructions for ESS-C-361n
Rev. 2022-08-12
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Instructions for ESS-C-377n
Rev. 2020-02-25
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Job Accommodation Form - ESS-C-185
Job Accommodation Form. Rev 2024-11-20
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Job Analysis - ESS-C-161 (1)
Rev 2022-09-22
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Job Analysis - ESS-C-161 (2)
ESS-C-161 Job Analysis. Rev 2022-09-22
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lan for Assessment - ESS-C-278 P
Rev 2022-09-12
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Placement Report - ESS-C-166
Rev. 2022-09-12
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Pre-Placement Information Form - ESS-C-157
Rev 2024-08-16
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R4 (4 Weeks Employment) Report- ESS-C-338
Rev 2023-08-09
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Record of Hours Worked - ESS-C-225
Record of Hours Worked. Rev 2024-11-22
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Situational Assessment Report - ESS-C139
Rev 2022-09-12
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Team Meeting Report - ESS-C-173
Team Meeting Report. Rev 2025-01-21
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Termination & Re-Placement Report - ESS-C-181
Termination & Replacement Report - Rev 2024-11-21
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Travel Log and Invoice - ESS-C-117
Travel Log and Invoice. Rev. 2024-12-23
