Exhibit_B_-_VR_Client_Service_Plan.pdf

VR Client Service Plan

Pre-Service Consultation Meeting Date: Self-Employment Assessment Date:

Business Plan Consultation Service Plan Meeting Date: Is this for: ☐Client ☐RSA Staff

Business Plan Development*: ☐Yes ☐No ☐N/A (for RSA staff)

Business Plan Implementation Follow Up Consultation ☐Yes ☐No ☐N/A (for RSA staff)

Contractor Company Name: _______________________________

Contractor Representative’s Name: __________________________

VR Client Name: ___________________________

VR Counselor Name: ________________________

RSA Authorization #: ________________________

VR Client Employment Goal in a Self-Employment work setting:

Full Time Employment Part Time Employment

Specific barriers to employment:

VR Client’s accommodation needs necessary for successful completion of the service objectives:

SPECIFIC SERVICE OBJECTIVES:

1. Self-Employment Assessment

☐ Complete an assessment of client’s self-employment strengths and weakness in the following areas:

☐Financial ☐Managerial ☐Marketing ☐Operations

☐Other:

☐ Review client’s Self-Employment Readiness Questionnaire (VR 1010A form)

2. Business Plan Consultation

☐ Review of client’s Business Plan Outline (VR 1012A form)

☐ Review client’s proposed business plan

☐ Provide guidance regarding the proposed business plan’s strengths and weaknesses

☐ Provide recommendations for improvement to the proposed business plan (if applicable)

☐ Assist client with making improvements to the proposed business plan (if applicable

*only for clients experience extreme difficulties with writing and developing their business plan and are unable to use available community resources to do so due to the nature of their disability.

3. Business Plan Development*

☐ Develop and write the self-employment business plan with the client

4. Business Plan Implementation Follow Up Consultation

☐ Yes ☐ No

Client Signature: ______________________________________ Date: ___________

VR Counselor Signature: _______________________________ Date: ___________

Contractor Signature: __________________________________ Date: ___________