FormsCenter

Driver Rehabilitation Forms Center


*Additional software may be required to download and view forms in PDF format.
Click here to download Adobe Acrobat PDF Reader

REFERRAL FORMS

Forms may be downloaded, completed and faxed to DRS office at 336-697-7842.

Referral from a Physician’s Office
Referral from a Vocational Rehabilitation Services or Independent Living Program Counselor
Referral from a Worker’s Compensation Case Manager or Adjuster
Referral of self from an Aging Driver or Aging Driver’s Family Member
Referral of a Special Needs Teen Driver

SERVICE CONTRACT & CONSENT TO RELEASE INFORMATION FORMS

These forms are for viewing purposes only.  Please DO NOT fax or email to DRS office.  Digital copies of these forms are signed by the client prior to service delivery.

Release of Information

Client Contract 2016

DIRECTIONS TO DRIVER REHAB

Directions to Driver Rehabilitation Servicess