Referral Form

Referral Form

Edison #0000272232
Welcome to VisionLink Solutions, LLC. just a word regarding services offered at this organization. We follow the Comprehensive, Sequential Rehabilitation and Vocational Training Framework. That means that specific training needs to be completed before attending other trainings. That sequence should follow the following:

Assessment Phase:
- Abilities/Vocational Evaluation: Determines interests, aptitudes, prior experiences, and potential vocational directions.
Foundational Skills Building Phase:
1. Orientation & Mobility (O&M) Assessment and Training : Ensures safe and independent tralvel, often the first cornerstone skill for independence.
2. Daily Living Skills Training: Covers adaptive daily living (ADL/ADLS), including cooking, cleaning, self-care, and organizational strategies.
3. Communication Skills Training: Includes braille literacy, large print strategies, auditory strategies, and social communication skills.
Technology & Communication Integration Phase:
- Assistive Technology Training: Builds independence in digital literacy (screen readers, magnification, smartphone use, braille displays...).
Vocational skills Development Phase:
1. Employment Skills Training: Build general workplace skills, such as soft skills, professional etiquette, teamwork, conflict resolution, time management, and career specific learning such as Microsoft Office, Customer Service.....
2. Employment Preparation: Career Exploration, pre-employment skills, resumes and cover letters, interviewing strategies, job searching training.
Employment Placement and Support Phase:
- Employment Specialist: Provides individualized job development, employer engagement, job coaching, and follow-up support.
Customer Information
Customer Name*

First NameLast Name
Customer Email*
example@example.com
Customer Phone Number*
Please enter a valid phone number.
Customer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Customer Preferred Method of contact:*

Phone VoicePhone Deaf ServicesText MessageEmailOther (specify in the Supported Goal Section)
Transportation Preference: (list company name and Email or self for individuals who will supply their own transportation)*
Supported Goal of Customer or other important information:*
Referring Counselor Information
Counselor Name*

First NameLast Name
Counselor Email*
example@example.com
Counselor Phone Number*
Please enter a valid phone number.
Assessments and Evaluations
Assessments/Evaluations Select all to perform

Abilities360 Evaluation - 2 day evaluation (full evaluation on customer's current abilities including Vocational Evaluation) $1,000Braille Evaluation State Fee Schedule (TN = $85.00/hr)(Minimum 4 hours)Communications and Home Management EvaluationVocational Evaluation $696Other Single Service Evaluation (Low Vision Lighting and Filters and more.)College Readiness Evaluation 2-day assessment; $1000 (Testing on Reading comprehension, math skills, computer literacy, note-taking skills, and more.)Assistive Technology EvaluationSelf-Employment Preparedness Evaluation In-Person/Virtual (2 day evaluation) $1000.00Other
Please specify if a particular evaluation is needed, we will contact you:
Skills Training
Please select the skills area needing training (Detailed descriptions available on website or upon request):

Foundation Skills for Independence 8 weeks/48 hours - In PersonIndependence to Employment 6-month comprehensive program that meets 4 days per week (see website for more info) $3,000/moEveryDay Tactile Skills 12 Weeks/72 hours - In Person Only $2100/moHiSet Exam Preparation min 6 mo - Virtual/In Person $1800 per monthBrailleQuest Program - Braille Literacy min 18 mo - In person only $65 per hourMicrosoft Word Mastery Virtual/In Person min. 3 mo./20 hrs per mo. $1800/mo.Microsoft Excel Mastery Virtual/In Person min. 3 mo./20 hrs per mo. $1800/mo.Microsoft Outlook Mastery Virtual/In Person - Min. 1 Mo./20 Hrs $1800/mo.Microsoft OneNote Mastery Virtual/In Person - Min. 1 mo./20 Hrs. $1800/moTechSteps: Basic Computer Literacy Skills Training Virtual/In Person - Min 2 months/40 Hrs. $1800/moJAWS Training Virtual/In Person - Min 3 mo/60 hrs $1800/mo.Narrator Training Virtual/In Person - Min. 3 mo./60 hrs $1800/mo.NVDA Training Virtual/In Person - Min 3 mo/60 hrs $1800/mo.Apple Mac VoiceOver Training Virtual/In Person - Min 4 mo/80 hrs $1800/mo.iPhone VoiceOver Training In Person $80/hr.Computer Magnification Training Virtual/In Person - 2 mo./40 hrs. $1800/mo.Other
Specify:
Employment Training Services
Check all approved services for this customer. (Visit www.VisionLinkSolutions.com for program descriptions)

CollegeConnect: College Support Program Virtual only - 12 months $900/mo.ServSafe Certification ($1800 includes exam) 2 week/4 days per week/24 hoursCareerBridge Program Virtual/In Person - 3 mo/60 hrs $1800/moOther
We are always open to exploring new career training options to better serve individuals who are blind or visually impaired. If you have a suggestion for a specific area of training we welcome your input and look forward to developing innovative programs that support independence and competitive employment. Please supply your suggestion in the blank below.
By submitting this referral form you are agreeing to supply an authorization within 1 week of submission for the above service. If a service is not listed above and/or you are unsure of which program to select please contact Meredith at 615-266-4030 or Meredith@VisionLinkSolutions.com
Should be Empty:

Referral Form

Customer Information

Referring Counselor Information

Assessments and Evaluations

Skills Training

Employment Training Services

By submitting this referral form you are agreeing to supply an authorization within 1 week of submission for the above service. If a service is not listed above and/or you are unsure of which program to select please contact Meredith at 615-266-4030 or Meredith@VisionLinkSolutions.com