A Community Rehabilitation Program that seeks to participate in the QRF Program must complete and submit this form.
All participating QRFs must utilize this form to submit information to DAS/SPO within 120 days of the end of their fiscal year.
Public Agencies not under DAS authority and QRFs entering into a contract must submit this form, completed with authorized signatures, the statement of work and costing workbooks to DAS for price determination.
QRFs must complete this form every two years for each employee with qualifying disabilities.
This Documentation of Disability form, signed by a medical professional, is an "Acceptable Disability Documentation Source."