Form # 412a:
The Vocational Rehabilitation Plan

Questions:
Client name

1. Has the client agreed to work with a rehabilitation counselor?
yes / no.

2. What is his most difficult problem?

3. What other problems does he have?

4. What are other job choices for him that will not exceed his physical limitations?

5. Is further schooling an option for him?
yes / no.

6. What job does he like to do?

7. What does the client's spouse think about the situation?

8. Who can help him with his job search and give him support?

9. Would this new job be an option for him?
yes / no.

10. Is the amount of monthly pay an important consideration?
yes / no.

11. What amount of money should he earn?

12. The long-term goal for the person and the intermediate objectives to reach that goal.

13. The counselor's responsibilities and the client's responsibilities.

14. The process to evaluate if progress is being made.

15. Any financial assistance given and who will give that money.

16. Notes about closing the case and the reason for closure. (Sometimes the case is closed because the goal was met, sometimes the case is closed because the client does not want rehabilitation.)