Dsb-4004-VR-ia-2025

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The document is an application form for vocational rehabilitation services provided by the North Carolina Department of Health and Human Services, specifically for individuals with visual impairments. It collects personal information, including demographics, contact details, disability status, income information, medical insurance coverage, education level, and work history. The purpose of the application is to assess eligibility for services aimed at helping individuals secure or retain employment.

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