DVR-17037-E, Job Hire Report Preview on Page 1

DVR-17037-E, Job Hire Report 2026

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  1. Click ‘Get Form’ to open the DVR-17037-E, Job Hire Report in the editor.
  2. Begin by entering the 'Report Month' and 'Report Year' at the top of the form. This helps in organizing your submissions effectively.
  3. Fill in the 'Consumer IRIS Number', 'Service Provider Name', and 'Consumer Name' as listed on the purchase order. Ensure accuracy for proper identification.
  4. Complete the 'Service Authorization Date', 'Report Date', and 'Report Author' fields to document when this report is being submitted.
  5. In the employment details section, provide information such as 'Job Title', 'Employer Name and Address', and specifics about wages and hours per week.
  6. Detail any benefits offered, including health insurance or vacation time, along with their start dates.
  7. If applicable, describe job duties and attach a position description if not already included. This ensures clarity on job expectations.
  8. Finally, review all sections for completeness before submitting your report within five days of hire to ensure compliance with requirements.

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Eligibility requirements are the following: A physical or mental impairment. Impairment constitutes or results in a significant impediment to employment for you; and. Require and can benefit from vocational rehabilitation services to prepare you to obtain, retain, or regain employment.
Typically, the first step of an I.P.E. is for D.V.R. to authorize job placement services to assist the supported employment customer in becoming employed. Once the customer is employed then D.V.R. authorizes intensive training services to assist the customer in learning how to perform their job satisfactorily.
Yes you can - your situation is exactly what Voc Rehab is for. You can be employed while in Voc Rehab - many veterans are.
The Division of Vocational Rehabilitation (DVR) is a partner in helping job seekers develop skill sets to find employment. We strive to build relationships with employers so our job seekers can compete for opportunities and obtain employment that meets their needs.
The Department of Rehabilitation (DOR) assists Californians with disabilities to obtain and retain employment and maximize their equality and ability to live independently in their communities. We do this by tailoring our services to each individual to ensure a greater chance of success.

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DVR-17037-E, Job Hire Report

This form is to be completed by DVR Service Providers to report on job development hire services authorized by DVR.

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