OVR Forms

​Application 

• OVR 7EO Employment Outcome Instructions 
  
• OVR 6 Consumer Cost Sharing Form
  
• OVR 6 Consumer Cost Sharing Form Instructions​
  
• OVR 6 Consumer Cost Sharing Appendix​
  
• ​OVR 6 Consumer Cost Sharing Appendix Instructions​​
​​OVR 19C Student Individual Responsibilities​​
• ​OVR 19C Student Individual Responsibilities Instructions 
  
• OVR 5 Trial Work Experience 
  
• ​Trial Work Experience Instructions
  
• OVR 5C Trial Work Experience Continuation Form​
  
• Trial Work Experience Continuation Instructions​​
  
• ​ Counselor Guide (Optional) for Required Data Elements for the IPE/Amendment or as needed​
  

Spanish Forms 

• 2024​ Consumer Guide - Spanish​​​
  
• OVR 2 Application - Spanish​​​
  
• OVR 2A Parent/Guardian Consent for Application​
  
• Fact Sheet​
  
• Additional Supports Fact Sheet​​
  
• Voter Registration Questionnaire​
• Eligibility Letter​
  
• Eligibility Letter Extension
• Certificate of Ineligibility​​
  
• OVR 7 Individualized Plan for Employment (IPE)​
  
• IPE Extension Agreement​
  
• OVR 7A IPE Amendment
• OVR 7C Continuation​
  
• OVR 7EO Employment Outcome
  
• OVR 5 Trial Work Experience Plan Form
• OVR 5C Trial Work Experience Continuation​
  
• Functional Limitations​
  
• OVR 10 Receipt and Transferrable Items Agreement​​
  
• OVR 10A Security Agreement​​ for Non-Transferrable Items
  
• OVR12 Employment Follow Up​
  
• OVR 15A Authorization for Release of Personal or Protected Health Information​​
  
• OVR 15B Written Consent for Release of Personal or Protected Health Information in Possession of OVR​​​
• OVR 15V Consent for Release of Verbal Exchange​​​
  
• PACE Acknowledgement Form​
  
• Pre-ETS Referral Form​​​​​
  
• Pre-ETS Referral Form Instructions​
  
• 511 Form​
  
• Appeal Rights Form P and A Spanish​
  
• OVR ​​Referral Form
• Photo and Multimedia Release Form​​​
  

• Appeal Rights Form
• ​Appeal Rights Form Instructions​​
• 2024​ Consumer Guide​​​​
  
• Consumer Payment Form​
  
• OVR 15A Authorization for Release of Personal or Protected Health Information​
  
• OVR 15A Instructions​​
• OVR 15B Written Consent for Release of Personal or Protected Health Information in Possession of OVR​​​​​​​​
  
• ​OVR 15B Instructions​
  
• OVR 15V Consent for Release of Verbal Exchanges​​​​
  
• Verbal Exchange Instructions​
  
• Verification for Subminimum Wage Employees​
  
• ​Verification for Subminimum Wage Employees Instructions​
  
• ​OVR 10A Security Agreement​​​ for Non-Transferable Items
  
• OVR 10A Security Agreement for Non-Transferable Items Intsructions​
  
• OVR 10B Equipment Recovery and Disposal Form
  
• OVR 10B Equipment Recovery and Disposal Form Instructions​
• OVR 12 Employment Follow-Up​​
  
• ​​Employment Follow-Up Instructions​
  
• Equipment Transfer​​​
  
• General Medical
  
• Visual Report Form​
  

Program Specific Forms

Blind Services Related (Rehab Tech - Independent Living -  Bioptic ​- DeafBlind - Orientation & Mobility​)

• Bioptic Driving Services Referral
  
• Deaf-Blind Services Referral
  
• Orientation and Mobility Services Referral
  
• Independent Living (IL) Services Referral​
  
• Bioptic Initial Exam
• Bioptic Annual Vision Exam
  
• Bioptic Visual Re-Examination

​

Pre-ETS

• ​​Eligibility Extension Outlook Instructions
• IPE Extension Outlook Instructions​
• Email Extension Instructions​
• Post Secondary Transition Program Worksheet
• ​ OVR 10 Receipt and Transferrable Items Agreement
  
• ​OVR 10 Receipt and Transferable Items Agreement Instructions​​​​
• Personal Care Attendant Tax Worksheet and Timesheet
• Interpreter Request Form
• OVR 19  Required Anticipated Sponsorship Notification​​
• ​OVR 19 Instructions​
• OVR 19A Training Participation Reconsideration Worksheet​​​​
• OVR 19A Training Participation Reconsideration Worksheet Instructions
• OVR 19C Student Individual Responsibilities​​​​
• OVR 19C Student Individual Responsibilities Instructions​​
• PFP Referral Form
• PFP Facilitator Survey​
• Support Service Provider Expectations

Job Placement 

• Job Placement Manual
  
• Fact Sheet
  
• Work Opportunity Tax Credit Forms and Information
  
• Closure Report​
  
• Job Placement-PACE Closure Form Instructions​
  
• Job Readiness Assessment (Consumer)​
  
• Job Readiness Assessment Instructions
  
• Job Readiness Assessment (Counselor)
  
• Job Placement Initial Interview​​
  
• Job Placement Initial Interview Instructions​
  
• Agreement for On the Job Training Services​
  
• Agreement for On the Job Training Services Instructions
• On the Job Training Flyer​​
  
• On the Job Training Evaluation
  
• Customized​ Employment Handout
  
• Customized Employment - Put it to Work For Your Business
  
• Customized Employment - Office of Disability Employment Policy

PACE​

• PACE Letter​​​​
  
• PACE Acknowledgment Form​
  
• OVR 18A Multiple Disclosures​
  
• OVR 18B Employer Agreement for Training Site
  
• OVR 18D Weekly Timesheet and Evaluation
  
• OVR 18F Participant Responsibilities Agreement​
• ​SRG Claim Form​
  

​

Assistive Technology & Driver Assistive Technology Program​​

• OVR 14 RT Referral Form
• OVR 14A DRTP Evaluation and Referral Form​
  
• OVR 14A DRTP Evaluation and Referral Form Instructions​​​​​
  
• Consent for Driver Services​
  
• Physician Consent Form​
  
• Medical Report of Visual Disability​​​
  
• Driver Rehab TechnologyProgram Services Program Fees​​​​
  

Self-Employment​

• Self Employment Process Flow Chart
  
• OVR 16A Self Employment Process Form
  
• ​​OVR 16A Self Employment Process Form Instructions
  
• OVR 16C Confidential Disclosure Agreement
  
• Feasibility Checklist for Consumers
  
• OVR 16B Counselor Review Form
  
• ​​​OVR 16B Counselor Review Form Instructions​
  
• Self Employment Tiers
  
• Start-Up Costs Table
  
• Calculation Worksheet
  
• Existing Business Checklist​
  
• Business Plan Checklist​
  

Social Security/Ticket to Work​​​

• Benefits Counseling Toolbox
  

• ky.db101.org​

• Benefits Analysis SFM​​

• Approved Benefits Counseling Providers

• ​​​​​​​​​​​​​​​​​​Benefits Counseling Powerpoint​​

• ​​Social Security Incentive Form
  

• Kentucky Employment Network Listing
• Kentucky Employment Network Listing by County​​
  
• Social Security Administration Release Form​
  
• Social Security Calculation Chart​​
• Social Security Benefits Cheat Sheet
  
• Social Security Fact Sheet​
  
• 1619b Fact Sheet
  
• Adjustments to Social Security Checks​​
  
• Ticket to Work Regulations - 2008
• Ticket to Work Regulations - 2001
• Ticket to Work Timely Progress Guidelines​
  
• Benefits Planning Query Handbook​
  
• Benefits Planning Query Request Cover Sheet​
  
• The Redbook: A Guide to Work Incentives
• Disability Materials for Groups and Organizations
• Faces and Facts of Disability
• Partnership Plus Fact Sheet​​​​
  

• Person Centered Employment Plan
  
• Person Centered Employment Plan Activity Note
  
• ​Person Centered Employment Plan Activity Note Instructions​
  
• Job Development Activity Note
  
• Job Development Activity Note Instructions​
  
• Job Acquisition Report ​​
  
• ​Job Acquisition Report Instructions
  
• Supported Employment Services Note
  
• Supported Employment Services Note Instructions​
  
• Employment Stability Assesment 
  
• Employment Stability Assessment Instructions
  
• ​​Extended Services Plan
  
• Extended Services Plan Instructions
  
• Extended Services Report​
  
• ​Extended Services Report Instructions​​​​​​
  
• Step Down Supports Plan​​

• ​Career Profile Plan​
• Job Search Plan
• Job Support Plan
• Job Development Activity Note​
• ​Job Development Activity Note Instructions​​
• Job Acquisition Report​
• Job Acquisition Report Instructions
• Supported Employment Services Note
• Supported Employment Services Note Instructions
  
• ​Employment Stability Assessment​
• ​Employment Stability Assessment Instructions
• Extended Services Plan
• ​Extended Services Plan Instructions
• ​Extended Services Report​
• Extended Services Report Instructions​​​​​​​​​​
• IPS Services Transition Plan​
• Library – The IPS Employment Center​​

• ​1 Day Report
  

• 45 and 90 Day Report
  

• Monthly Report​​​
  

• CRP Manual
  
• OVR Staff Guidance for Purchase of Supported Employment​
  
• Supported Employment Flowchart​​​
  
• Phases of Services
• Contact Log
  
• Supported Employment Training Project
  
• Employment Specialist CEU Verification Form​​​​​
  
• Customized Employment in Kentucky​
  
• Pre-Vocational Proposal Guidelines​​​​​​​​​​
  

• CDPVTC Application​​​
  
• ​OVR-35 Instructions​
  
• CDPVTC Referral Checklist​​​​​​
  
• ​OVR 35-A Checlist Instructions​​​

Charles W. McDowell Center​​

State Employee Travel Forms

• ​​State Employee Travel Voucher​​
  
• eMars 36 Travel Voucher​
  

​​​Vendor Forms

Miscellaneous Forms