This section includes a variety of forms that could be used to document HVRP practices. The presentation of these forms does not mean NVTAC or US DOL-VETS endorses any particular form as required, or as an approved form. These forms were collected from service providers and are only intended to help program planners develop forms and tools that will serve the needs of their program.
The forms this section are samples for your perusal and information. If program planners would like to use or modify any of these forms for their use, we encourage you to do so.
Intake and Assessment Forms
- Complete the preliminary Assessment Sheet, to gather general information from client.
- The Determining Readiness for Employment Form helps to determine an individual’s readiness for employment.
- Is your client eligible to receive HVRP benefits? Find out by completing the HVRP Eligibility Assessment Form.
- Use the HVRP SSVF Employment and Education Assessment form to assess your clients HVRP/SSVF employment eligibility, and educational history.
- The Supportive Service Needs Checklist will help you to determine the client’s primary needs.
- Is your client eligible for the Veterans Work Program? Use the Veterans Work Program Intake Application Assessment.
- The Vulnerability Index and Services Prioritization Decision Assistance Tool (VI-SPDAT) is helpful in prioritizing the needs of the client.
Homeless Certification Forms
- Intake Counselors utilize the Homeless Certification form to verify and confirm that a client is homeless.
- Use the HPRV Documenting Veteran and Homeless Status form to assist you with documenting a Veteran’s Homeless status.
- Clients use the HVRP Self Attestation Form to declare their homeless status.
Participant Agreement Form
Individual Employment Plan (IEP) Forms
- The Adult Dislocated Worker Employment Plan form will assist Case Manager or Intake counselor in determining the physical limitations of their client.
- The Adult Dislocated Worker Training Plan is a set of cohesive and practical tip to assist staff/agency personnel in developing a training plan.
- The Employment History form provides an extensive look into the client’s Employment history.
- Collaborate with your client and create a custom made Individual Employment Plan.
- Assess past employment and training experience with the Inventory of Employment Training Issues form.
- Determine needs for service and/or training with the Overcoming Identified Barriers/Needs form.
- The Veterans Services Individual Employment Plan is a template for a client Employment Plan.
Job Retention Forms
- Use the Employment Verification Form to collect client employment verification information.
- An additional or alternative Employment Verification form is also available.
- The Job Retention Proposal is an agreement between client and job developer that focuses on job retention plans.
- Is the participant actively participating in their retention process? Use the Monthly Job Placement/Retention Progress Report to track a client’s progress.
Progress Notes Form
- Track client information, including 30, 60, 90 day follow ups and exit with HVRP Client Case Notes.
Client Folder Organization Forms
- The Enrollment instructions for HVRP Folders checklist assists with HVRP Folder preparation.
- Use the Folder Make up Instructions for Logging In and Placing Documents checklist for logging all documents and information.
- Case Managers use this important form for Assessing Job Traits and Matching Occupations.
- Use the MHVRP Program Referral for Services Form for Veteran clients.
- The HVRP Service Satisfaction Survey helps provide quality employment information from the veteran point of view. This form is required to be completed by the veteran at placement or retention.
- Clients can use this financial planning template to create a Monthly Budget.
If you have questions, need assistance or have a success story to share, please contact us.