ESS-C-702—IPS Authorization Request Form (Rev. 2021-03-01) FY22

Form Number: 

ESS-C-702

The ESS-C-702—IPS Authorization Request Form (Rev. 2021-03-01) will be completed by the Employment Specialist and submitted to the DRS Counselor when requesting the initial authorization and subsequent authorizations for the Individual Placement Supports (IPS) contract.

Document: 

File Origination or Revision Date: 

Rev. 2021-03-01