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Sign Up/Forms
If you are currently receiving SSDI or SSI and are working, thinking of accepting a new job or promotion, then call us to get vital information that can enhance your decision and keep you in compliance with Social Security requirements.
The forms here will help initiate the Work Incentive Planning process. Work Incentive Planning is meeting with a trained CWIC (Community Work Incentive Coordinator) and looking at your particular work situation as well as your goals and desires. When you've started the Work Incentives Planning process, the CWIC will show you the effect of a number of work incentive options so you can make informed choices to advance your goals, and will provide ongoing information to assist throughout your plan.
You can submit your form in whatever way works best:
Fax: 509-444-3077
Email: staciec@community-minded.org
Mail: 25 W Main, Ste 310
Spokane, WA 99201
Sign up today for our free service to begin planning for your employment future!
Intake Form
This form allows us to get a complete picture of your work goals and benefit needs. Filling this out as completely as possible will ensure that we're giving you accurate, up-to-date information.
Social Security Release of Information #1
Social Security Release of Information #2
Both of these releases of information allow us to tailor your benefits analysis and work incentives planning to your specific benefits from Social Security. We do need both to be signed, even though the look the same. Verifying your benefit information is vital to planning for employment and becoming more in charge of your finances.
Rights and Responsibilities
This form is to give you information about privacy, grievance procedures, the scope of our services, and your rights and responsibilities when you are using Plan to Work's services. Please print one off for your records, and also sign one and return it with the rest of your intake information.
General Release of Information
This release is for anyone else you'd like us to be in contact with as you go about your planning process. This could include service providers, case managers, or anyone else you're wanting to be a part of your employment team.
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