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  • MassAbility Pre-Employment Transition Services Referral and Consent Form

    MassAbility Pre-Employment Transition Services Referral and Consent Form

  • I. Demographics

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  • II. Family/Emergency Contact

  • III. School Information

  •  - -
  • IV. Services Requested

  • V. Consent for Service

  • I am requesting Pre-Employment Transition Services based upon the criteria that I am a student with a disability. I understand I will need to meet with a Pre-ETS Provider and develop a service plan that will be approved by MRC before I start receiving services. I understand that, as a recipient of services from MRC, I have the right to seek advocacy services from the Client Assistance Program (CAP) at 1-800-478-1234 or http://www.dlc ma.org/.

    For the specific purpose of participation in Pre-Employment Transition Services, I grant permission for the service provider to exchange information with the schools, authorized personnel, and MRC to verify services were provided to me.

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