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Department of Health and Human Services Division of Vocational Rehabilitation ServicesPolicy Directives Independent Living Services ProgramEffective Date: July 1, 2010, Revision Date: August 21, 2023Volume
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Start by downloading the RSA-PD-21-01pdf form from the official website.
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Fill out your personal information including name, address, and contact details.
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Include any relevant medical history or conditions that may impact your rehabilitation services.
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Sign and date the form before submitting it to the appropriate rehabilitation services provider.

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Individuals who are in need of rehabilitation services due to injury, illness, or disability.
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People seeking assistance to improve their physical, mental, or emotional well-being through therapy and support.
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Those looking to regain independence and improve their quality of life through specialized rehabilitation programs.
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The rsa-pd-21-01pdf is a form used to report rehabilitation services data, including information on programs assisting individuals with disabilities to achieve employment.
State agencies that provide vocational rehabilitation services are required to file the rsa-pd-21-01pdf to report their activities and outcomes.
To fill out the rsa-pd-21-01pdf, agencies must provide accurate data related to rehabilitation activities, services delivered, participant outcomes, and financial information as outlined in the form instructions.
The purpose of the rsa-pd-21-01pdf is to collect data on the effectiveness and reach of rehabilitation services, facilitating funding decisions and performance evaluations.
The collected information includes demographic data of participants, types of services provided, employment outcomes, and fund utilization.
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