Ovr application pdf 2026

1. Click ‘Get Form’ to open the OVR application PDF in the editor.
2. Begin by filling out the 'Referral Information' section. Enter your name, date of birth, and diagnoses in the respective fields.
3. Provide your physical address and mailing address if it differs. Ensure to include all contact numbers: home, cell, and work.
4. If applicable, fill in the 'Designated Representative' section with their name, relation to you, and contact information.
5. Select the referring agency by checking one of the options provided. Include the representative’s name and office address along with their contact details.
6. Indicate whether you want to be notified when the Intake Interview is scheduled by selecting YES or NO.
7. Specify who should receive information/application by selecting from the options provided.
8. Attach any necessary documents as indicated at the bottom of the form before submitting.
9. Finally, sign and date the form in the designated area before submitting it via email or printing it out.

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