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Saturday, November 14, 2009
Chickasaw Cornstalk Shoot

The event took place at Cultural Services in Ada.


83 photos
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Tuesday, November 10, 2009
Youth Heritage Day

Youth Heritage Day held at the Tishomingo Wildlife Refuge east of Tishomingo Oklahoma.  Johnson O'Malley students learned about their heritage and had a day of fun.


44 photos
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Friday, October 30, 2009
Ada Head Start Trick or Treat

The Ada Halloween Celebration Trick or Treat event held in the old Gym on the Headquarters Campus.


97 photos
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Vocational Rehabilitation
View: 
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 Forms  
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 Map  
Form BUL04 - 
2009-2010 Maximum Allowable Training Costs -  25 KB
Form CM01 - 
Certification of Eligibility -  256 KB
Form CM02 - 
Individual Plan for Employment (IPE) -  480 KB
Form CM03 - 
Extension to Determine Eligibility -  257 KB
Form CM04 - 
Certification of Ineligibility -  282 KB
Form CM05 - 
Annual Program Review -  269 KB
Form CM06 - 
Closing Summary -  252 KB
Form CM07 - 
Case Narrative -  242 KB
Form CM08 - 
Vocational Rehabilitation Story -  245 KB
Form CM09 - 
Consumer Case Record Review -  417 KB
Form CM10 - 
On-The-Job Training Monthly Progress Report  -  264 KB
Form CM11 - 
Counselor Case Transfer Report -  310 KB
Form CS01 - 
Psychological Consultant's Review -  246 KB
Form CS02 - 
Medical Consultant's Review -  291 KB
Form CS03 - 
Visual Consultant's Review -  267 KB
Form CS04 - 
General Health Checklist -  281 KB
Form CS05 - 
Chemical Dependency Consultant's Review  -  246 KB
Form ID01 - 
Referral to the Chickasaw Nation Vocational Rehabilitation Program  -  259 KB
Form ID02 - 
Application for Vocational Rehabilitation Services (Consumer Rights and Remedies) -  246 KB
Form ID03 - 
Consumer Initial Intake Information -  289 KB
Form ID04 - 
Statement of No Income/Statement of Residency  -  242 KB
Form ID05 - 
Documentation Checklist  -  266 KB
Form ID06 - 
Consumer Responsibilities  -  241 KB
Form ID07 - 
Release of Confidential Information  -  262 KB
Form ID08 - 
Referral from the Chickasaw Nation Vocational Rehabilitation Program  -  251 KB
Form ID09 - 
Special Services Request to OK DRS -  262 KB
Form LT01 - 
Annual Program Review Letter -  851 KB
Form LT02 - 
Appointment to Sign IPE Letter -  666 KB
Form LT03 - 
Business Plan Questionnaire Letter -  855 KB
Form LT04 - 
Case Review Letter for Funding -  857 KB
Form LT05 - 
Closing Due to Consumer Moving Letter -  853 KB
Form LT06 - 
Closing Summary Request Letter -  870 KB
Form LT07 - 
Determined Eligible Letter -  854 KB
Form LT08 - 
Determined Ineligible for Various Reasons Letter -  528 KB
Form LT09 - 
Determined Ineligible Letter -  853 KB
Form LT10 - 
End of Semester Letter to Consumers in Training -  854 KB
Form LT11 - 
General Appointment Letter -  854 KB
Form LT12 - 
Have Not Received Medical Info Letter -  857 KB
Form LT13 - 
Ineligible (Disability-Alcohol Drug Dependence) Letter -  55 KB
Form LT14 - 
Initial Interview Appointment Letter -  857 KB
Form LT15 - 
Inquiring About Interest Letter -  651 KB
Form LT16 - 
Lost Contact Letter -  652 KB
Form LT17 - 
Missed Appointment Letter -  653 KB
Form LT18 - 
Please Sign IPE Letter -  652 KB
Form LT19 - 
Receipt of Services Form Letter -  854 KB
Form LT20 - 
Request for Additional Info to Determine Eligibility Letter -  857 KB
Form LT21 - 
Request for Completion of Consultant's Report Letter -  857 KB
Form LT22 - 
Service Provided to Consumer Letter -  857 KB
Form LT23 - 
Transfer to New Counselor Letter -  854 KB
Form LT24 - 
Update Case Letter -  857 KB
Form LT25 - 
Consumer Satisfaction Survey Letter -  53 KB
Form LT26 - 
Consumer Satisfaction Review -  656 KB
Form O02 - 
Monthly Report -  254 KB
Form O03 - 
Fax Routing Form -  242 KB
Form O04 - 
Memo -  240 KB
Form O05SP - 
Consumer Satisfaction Survey – Small Print -  153 KB
Form O05LP - 
Consumer Satisfaction Survey – Large Print -  366 KB
Form VS01 - 
Statement of Appointment Attendance  -  242 KB
Form VS02 - 
Consumer Progress Report -  408 KB
Form VS03 - 
Probation Plan -  219 KB
Form VS04 - 
Receipt of Service -  242 KB
Form VS05 - 
General Authorization -  448 KB
Form VS06 - 
Business Plan Questionnaire  -  255 KB
Form VS07 - 
Consumer Budget for Training  -  253 KB
Form VS08 - 
Consumer Mileage Report  -  246 KB
Form VS09 - 
Consumer Work Log -  458 KB
Form VS10 - 
Training Progress Report  -  274 KB
Form VS11 - 
Absences/Grade Policy for Consumers in Training  -  242 KB
Form VS12 - 
Consumer Service Log  -  244 KB
Form VS13 - 
Job Search Log  -  245 KB
Form VS14 - 
Needs Analysis  -  253 KB
Form 378 - 
Check Request -  172 KB
Form 605 - 
Authorization for Access by Patient or Disclosure of Protected Health Information -  268 KB
Form 924 - 
Special Needs Assistance for Chickasaw Citizens with Disabilities -  108 KB
Brochure -  408 KB
(75) Forms

222 S. Mississippi
Ada, OK 74820
(580) 436-0553
TDD: (580) 310-9364
Fax: (580) 436-0830 


voc rehab group photo

voc rehab group photo

Mission:
To enhance the lives of American Indians with disabilities through successful employment outcomes.

Vision:
To be a model program that sets a standard of excellence for tribal vocational rehabilitation across the nation.

This program provides services to Native Americans with disabilities in a manner consistent with each individual consumer’s strengths, resources, priorities, concerns, abilities and capabilities. Vocational rehabilitation programs are designed to assist people with disabilities in returning to the workplace. Required forms are available at the telephone number above or the website below. Notification of program eligibility occurs within 60 days of submission of documentation.

Please email our office with any questions or to request information.

Vocational Rehabilitation Consumer Satisfaction Survey
Fine Print

Vocational Rehabilitation Consumer Satisfaction Survey
Large Print

Eligibility

  • Must reside within the Chickasaw Nation
  • Documented physical or mental disability which results in a substantial impediment to employment

You Provide

  • Proof of income
  • Membership in a state or federally recognized tribe
  • Social Security card
  • Proof of age
  • Mailing address/verification of residency
  • Proof of disability (if applicable)

Chickasaw Nation Service Area Counties

Bryan Carter Coal  Garvin  Grady
Jefferson Johnston Love  Marshall  McClain
Murray Pontotoc Stephens    

Application Process

  1. Contact the Chickasaw Nation Vocational Rehabilitation Program either by phone or in person.
  2. A vocational rehabilitation team member will take some basic referral information and either hand, mail, or fax you an application packet to complete.
  3. A vocational rehabilitation team member will contact you to schedule an appointment with a vocational rehabilitation counselor for an initial interview.
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