Success Story

logo, Oklahoma Rehabilitation Services.

(This form is voluntary)

I authorize DRS to use this information to educate the public, Oklahoma legislators, US Congress members and/or the media about DRS services and my success. I hereby release Oklahoma DRS, partner agencies and authorized agents from liability or claims arising out of the use of my name, photo or video and the information provided on this form.

By submitting this form online I give permission to use the information without a signature signed with an ink pen.
Name *
Disability Type
Mailing Address
DRS services provided (check all that apply)
Share your success story about how DRS has helped you: (Compare your situation before and after DRS: newly acquired job or return to work, educational experience, assistive technology solution, funding assistance, greater independence in the home or the classroom)

Submitting this form indicates that you give permission to use the information without a signature.

DRS-C-201 Revised 12/13/2023