Vocational Evaluation & Rehabilitation Services, Inc.

USE THIS FORM TO MAKE REFERRALS OR REQUEST ADDITIONAL INFORMATION

YOUR INFORMATION:
NAME:
COMPANY:
STREET ADDRESS:
CITY: STATE:   ZIP CODE :
COUNTRY:    TELEPHONE:
FAX:       E-MAIL :
INDIVIDUAL(S) BEING REFERRED:

REQUEST FOR SERVICES:
Vocational Rehabilitation Services    Employability Assessments
Career Counseling                                  Vocational Testing & Evaluation
Pre-Employment Testing                    Labor Market Survey
Long Term Disability Evaluation         Job Development/Placement
Consulting Services                                 Vocational Expert Witness
On-Site Job Analysis                   Other

                         Send us your comments or suggestions:

V.E.R.S.
P.O.Box 90591 - Albuquerque NM 87199
Telephone: (505) 822-8964
Fax: (505) 822-8974
E-mail: info@voceval.com