DVR Interest & Referral Form
We are excited you are interested in learning more about DVR. We work with people who have a documented disability to empower them to reach their employment goals through providing a variety of services. Please fill out the form below so that we can connect you with the office closest to you! A DVR staff person will respond to you within 2 business days. Please do watch our Orientation Video to see if our services are what you are looking for! Do know that if you are interested in our services, the next step is an application and an initial engagement meeting.
If you need immediate assistance, please contact us at
Orientation to DVR Video: Please watch first to see if we are the right program for you!
Name (first and last)
Best phone number to reach you
How would you prefer to be contacted:
Your address: street, city, zip code
If you know which DVR location would best work for you, please indicate below:
Blind and Low Vision Unit
Centennial (@ the Arapahoe/Douglas Works Workforce Center)
Denver Metro (office at 2211 W. Evans)
Are you: (Answering this will help us connect you with the right counselor. Many of our counselors specialize in working with youth, or with specific disabilities. Please check all that apply.)
Enrolled in high school with an IEP
Enrolled in a post secondary program with a 504 plan
A youth aged 16 - 21
Adult over the age of 25 looking for employment
Blind or low vision
Hard of hearing (for example, need assistance in obtaining hearing aids to fully engage in work)
Experiencing mental health or behavioral health challenges (could include PTSD, depression, schizophrenia, anxiety)
Neurodiverse or on the autism spectrum
Working with a local community centered board (CCB)
Physical mobility barriers
Spinal cord injury
How did you learn about DVR?
Post Secondary Program
School to Work Alliance Program
Community Mental Health Center
Community Centered Board (CCB)
Center for Independent Living
Ticket to Work
How can DVR help you with employment?
Short or long term training (may include on-the-job training, certificate program, or further post-secondary training)
Job development (may include 1:1 assistance in finding a job, either from internal or external providers)
Job coaching (individualized supports while on the job, may be on or off site)
Orientation and Mobility Training (assistance with learning new environments for those who are Blind)
Mental restoration services (may include working with a psychologist, therapist, or other services to support behavioral health needs)
Physical restoration services (could include physical therapy)
Assistive technoloy (may include accommodations, may be technology such as screen readers)
Self-Employment services (assistance in starting a new business)
Assistance in applying for disability benefits such as SSI or SSDI
Please tell us your comfort level with various technology, including computer skills and virtual meetings.
Highly experienced and comfortable
If you are completing this form on behalf of another individual, please tell us the best way to reach you if needed:
Do you have any questions for us?
Please tell us the best time of day to reach you.
Send me a copy of my responses.
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This form was created inside of State.co.us Executive Branch.