Supported Employment Contract and Forms

Job Seekers Pages

DRS Programs

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

Email ESS

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SE Specific Forms

ESS-C-241 Onsite Supports and Training Report (Rev 2021-12-30)
ESS-C-253 Extended Services Statement (Rev 2022-09-12)
ESS-C-430 Stabilization Milestone Report (Rev 2023-01-06)
Extended Services Report
Onsite Supports and Training Report
ESS-C-241 Onsite Support and Training Report Rev 2021-09-02
SE R8 Employment Report - ESS-C-425
Rev. 2024-08-16

2025 General Forms

Assessment Milestone Report - ESS-C-310
Rev 2023-01-05
Authorization Request and Invoice - ESS-C-801
Rev 2024-08-01
Contractor Staff and Training Tracking Form - ESS-A-005
Contractor Staff and Training Form. Rev. 2024-12-19
Customized Assessment(s) (ERC) - ESS-C-305n
Rev 2022-09-08
DRS Counselor Monthly Update Form - ESS-C-133
Rev 2024-11-20
DRS Counselor Response to ESS-C-278 Plan for Assessment ESS-C-278n
Rev 2022-07-08
Educational Experience Report (when in training) - ESS-C-710
Rev 2022-08-31
EM Record of Hours Worked for EM 90-Day Milestones-Services - ESS-C-225 (4)
(Rev 2022-09-22)
Employee Performance Report - ESS-C-810
Rev 2022-09-02
Employee Satisfaction Survey - ESS-C-249
Rev 2021-09-09
Employment Outcome Report - ESS-C-266
Employment Outcome Report. Rev 2024-11-22
Employment Verification Form
Rev 2022-09-21
HC ST Record of Hours Worked for EM 16 Week Milestones - ESS-C-225 (2)
Rev 2022-09-22
Incentive Payment Request Form - ESS-A-020
Rev 2023-04-18
Incentive Payment Request Form - ESS-A-020
Incentive Payment Request Form. Rev 2025-01-21
Instructions for ESS-C-145n
Rev. 2022-08-12
Instructions for ESS-C-149n
Rev. 2022-08-12
Instructions for ESS-C-153n
Rev. 2022-08-12
Instructions for ESS-C-197n
Rev. 2022-08-12
Instructions for ESS-C-213n
Rev. 2020-09-02
Instructions for ESS-C-237n
Rev. 2022-08-12
Instructions for ESS-C-285n
Rev. 2022-08-12
Instructions for ESS-C-289n
Rev. 2020-02-25
Instructions for ESS-C-361n
Rev. 2022-08-12
Instructions for ESS-C-377n
Rev. 2020-02-25
Job Accommodation Form - ESS-C-185
Job Accommodation Form. Rev 2024-11-20
Job Analysis - ESS-C-161 (1)
Rev 2022-09-22
Job Analysis - ESS-C-161 (2)
ESS-C-161 Job Analysis. Rev 2022-09-22
lan for Assessment - ESS-C-278 P
Rev 2022-09-12
Placement Report - ESS-C-166
Rev. 2022-09-12
Pre-Placement Information Form - ESS-C-157
Rev 2024-08-16
R4 (4 Weeks Employment) Report- ESS-C-338
Rev 2023-08-09
Record of Hours Worked - ESS-C-225
Record of Hours Worked. Rev 2024-11-22
Situational Assessment Report - ESS-C139
Rev 2022-09-12
Team Meeting Report - ESS-C-173
Team Meeting Report. Rev 2025-01-21
Termination & Re-Placement Report - ESS-C-181
Termination & Replacement Report - Rev 2024-11-21
Travel Log and Invoice - ESS-C-117
Travel Log and Invoice. Rev. 2024-12-23