Individualized continuation rehabilitation: Fill out & sign online

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Click ‘Get Form’ to open the form 28 8872 in the editor.
Begin by entering the date at the top of the form. This is essential for tracking your rehabilitation plan.
Fill in your full name (first, middle, last) and claim number in the designated fields to ensure proper identification.
Provide your Social Security Number in the appropriate section for verification purposes.
Select one program plan from options like IEEP, IWRP, or ILP by checking the corresponding box.
If applicable, complete sections for amendments by filling out items 6B and 6C with relevant details.
Outline your program goals and objectives in sections 7 through 10, ensuring to include anticipated completion dates and services provided.
For each objective, specify evaluation criteria and procedures to track progress effectively.
Finally, sign and date the closure statement at the end of the form to certify your participation in developing this plan.

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