WORKING. I DO / DO NOT want help with decisions about working. Here is a list of people I want to help me: First and Last Name Relationship Home Address Email Phone Number Write Y for “yes” or N for “no” to say if your Supporters can or cannot help with each option. / Help me choose if I want to work. All Supporters/ Only Supporters Listed Here: / Help me understand my work choices and apply for jobs. / All Supporters/ Only Supporters Listed Here: Help me understand how working will affect my benefits (Social Security, Medicaid, etc.). / All Supporters/ Only Supporters Listed Here: Help me understand the benefits I can have at work (vacation time, sick leave, time off, etc.). All Supporters/ Only Supporters Listed Here: / Help me request benefits at work (vacation time, sick leave, time off, etc.). / All Supporters/ Only Supporters Listed Here: Help me make decisions about transitional services (services as I transition out of high school). All Supporters/ Only Supporters Listed Here: / Help me explore and make decisions about internships, apprenticeships, and/or mentoring. / All Supporters/ Only Supporters Listed Here: Help me make decisions about whether I need to take more classes or training to get a job I want, and help taking these classes. All Supporters/ Only Supporters Listed Here: / Help me make decisions about supported employment or other supports and services I need in order to work. All Supporters/ Only Supporters Listed Here: / Attend meetings about my employment with my employment supporters, including Vocational Rehabilitation or other employment agencies. All Supporters/ Only Supporters Listed Here: / Help me with career preparation and placement. All Supporters/ Only Supporters Listed Here: / Help me request accommodations for my work. All Supporters/ Only Supporters Listed Here: / Help me get to and from work every day. All Supporters/ Only Supporters Listed Here: / Help me talk to my employer. All Supporters/ Only Supporters Listed Here: / Help me tell people what I want and what I don’t want regarding my work and work related supports. All Supporters/ Only Supporters Listed Here: / Help me tell people how I make choices about my work and work related supports. All Supporters/ Only Supporters Listed Here: / Make sure people understand what I am saying about my work and work related supports. All Supporters/ Only Supporters Listed Here: To help me with my work these supporters may also do these things: (Examples: Talk to my employment supports, help me understand and decide my work schedule, talk to my employer or supervisor) These supporters MAY NOT do these things to help me with my work: (Examples: May not talk to my supervisor or employer without my consent, may not visit me at work, may not talk with my employment supports without my consent, may not dictate my work schedule)
Appears in 3 contracts
Samples: Supported Decision Making Agreement, Supported Decision Making Agreement, Supported Decision Making Agreement
WORKING. I DO _X_ / DO NOT want help with decisions about working. Here is a list of people I want to help me: First and Last Name Relationship Home Address Email Phone Number Xxxx Xxxxx Dad 000 Xxxx Xx., Xxxxxxxx, XX 00000 Xxxx.x.xxxxx@xxxxx.xxx 000-000-0000 Xxxx Xxxxx Mom 000 Xxxx Xx., Xxxxxxxx, XX 00000 Xxxx.xxxxx0@xxxxx.xxx 000-000-0000 Xxxxxx Xxxxx Theater Coach 000 Xxxxx Xx.,Richmond, VA 23234 xxxxxxxxx@xxxxx.xxx 000-000-0000 Write Y for “yes” or N for “no” to say if your Supporters can or cannot help with each option. / _N_ Help me choose if I want to work. All Supporters/ Only Supporters Listed Here: / _Y_ Help me understand my work choices and apply for jobs. / _X_ All Supporters/ Only Supporters Listed Here: _Y_ Help me understand how working will affect my benefits (Social Security, Medicaid, etc.). / _X_ All Supporters/ Only Supporters Listed Here: _Y_ Help me understand the benefits I can have at work (vacation time, sick leave, time off, etc.). _X_ All Supporters/ Only Supporters Listed Here: / _N_ Help me request benefits at work (vacation time, sick leave, time off, etc.). / All Supporters/ Only Supporters Listed Here: _N_ Help me make decisions about transitional services (services as I transition out of high school). All Supporters/ Only Supporters Listed Here: / _Y_ Help me explore and make decisions about internships, apprenticeships, and/or mentoring. / All Supporters/ _X_ Only Supporters Listed Here: Xxxxxx Xxxxx _Y_ Help me make decisions about whether I need to take more classes or training to get a job I want, and help taking these classes. All Supporters/ _X_ Only Supporters Listed Here: / Xxxxxx Xxxxx _Y_ Help me make decisions about supported employment or other supports and services I need in order to work. All Supporters/ Only Supporters Listed Here: / _Y_ Attend meetings about my employment with my employment supporters, including Vocational Rehabilitation or other employment agencies. _X_ All Supporters/ Only Supporters Listed Here: / _N_ Help me with career preparation and placement. All Supporters/ Only Supporters Listed Here: / _Y_ Help me request accommodations for my work. _X_ All Supporters/ Only Supporters Listed Here: / _Y_ Help me get to and from work every day. _X_ All Supporters/ Only Supporters Listed Here: / _N_ Help me talk to my employer. All Supporters/ Only Supporters Listed Here: / _N_ Help me tell people what I want and what I don’t want regarding my work and work related supports. All Supporters/ Only Supporters Listed Here: / _N_ Help me tell people how I make choices about my work and work related supports. All Supporters/ Only Supporters Listed Here: / _Y_ Make sure people understand what I am saying about my work and work related supports. _X_ All Supporters/ Only Supporters Listed Here: To help me with my work these supporters may also do these things: (Examples: Talk to my employment supports, help me understand and decide my work schedule, talk to my employer or supervisor) None. These supporters MAY NOT do these things to help me with my work: (Examples: May not talk to my supervisor or employer without my consent, may not visit me at work, may not talk with my employment supports without my consent, may not dictate my work schedule)) None.
Appears in 3 contracts
Samples: Supported Decision Making Agreement, Supported Decision Making Agreement, Supported Decision Making Agreement