To fill out IPS employment forms, download the current Career Profile, Disclosure Worksheet, and Employer Contact Log from the IPS Employment Center at ipsworks.org, then complete each one in the client’s own words during the first few weeks of service and keep them updated as the job search progresses.1The IPS Employment Center. Sample Employer Contact Log Each form has a specific job: the Career Profile captures who the person is and what work they want, the Disclosure Worksheet documents what the specialist may say to employers about the client’s disability, and the Employer Contact Log tracks every outreach visit.
Start With the Right Template
The IPS Employment Center posts the Career Profile, Disclosure Worksheet, and a sample Employer Contact Log under the “Documents” section of ipsworks.org in Word or PDF format at no cost.1The IPS Employment Center. Sample Employer Contact Log Some state behavioral health departments distribute adapted versions through their own portals, sometimes adding sections for education goals or adjusting the layout to match an electronic health record. If your program uses a state-adapted template, confirm with your supervisor before you start filling anything out, because an outdated version will be flagged in a records audit.
Filling Out the Career Profile
The Career Profile is the intake document that drives everything that follows. Employment specialists complete it during the first few weeks with a new client, pulling information from the client directly, the mental health treatment team, clinical records, and, with permission, family members or previous employers.2The IPS Employment Center. Career Profile Form
The form opens with a referral face sheet: basic contact details, the client’s case manager or therapist, and whether a referral has been sent to the state vocational rehabilitation agency. After that come three open-ended sections.
Work Goals
This section asks what type of job the person wants now, what appeals to them about that work, and what jobs they know they would not want. There is space for long-term career goals and for any worries about returning to work. Let the client talk first. The questions are person-centered and strengths-based, so resist the urge to interpret or steer. Record the client’s own words when you can. “I want to work with animals” is more useful for job development than a specialist’s summary of the same idea.
Education
Record whether the client finished high school, participated in vocational training, completed an apprenticeship, or earned any post-secondary degrees or certificates.2The IPS Employment Center. Career Profile Form
Employment History
List past jobs with titles, dates, and reasons for leaving. Short entries are fine. What matters is accuracy and consistency over time.
Update the Career Profile every time the client starts or ends a job or begins a new educational program. A profile that still describes a client as unemployed six months into a job is one of the first things a supervisor or fidelity reviewer will notice.
Filling Out the Disclosure Worksheet
The Disclosure Worksheet is a structured conversation tool, not a binding legal document, but it ends with signature lines for both the job seeker and the employment specialist so the client’s preferences are documented.3The IPS Employment Center. Disclosure Worksheet – English Version Work through it in a sit-down conversation rather than handing it to the client to complete alone.
The worksheet first walks through the advantages and disadvantages of disclosing a disability to an employer. It then asks the client to choose a preference from several options:
- The specialist should not talk to employers at all.
- The client wants more time to decide.
- The specialist may share job leads without disclosing personal information.
- The specialist may approach employers on the client’s behalf.
If the client picks the last option, the form includes space to specify exactly what information is acceptable to share and what should remain private.4The IPS Employment Center. Disclosure Worksheet Write those boundaries down concretely. “You can say I have a disability but not name it” is a usable instruction; “use your judgment” is not.
Revisit the worksheet periodically. A client who initially declines disclosure may change their mind once they feel more comfortable in the job search, and the reverse happens too. Any health information the client shares on this form falls under HIPAA, and the 2026 inflation-adjusted civil penalties run from $145 per violation at the low end up to $73,011 per violation for willful neglect that goes uncorrected, with calendar-year caps reaching $2,190,294.5Federal Register. Annual Civil Monetary Penalties Inflation Adjustment Treat the completed worksheet as protected information from the moment it is signed.
Filling Out the Employer Contact Log
Each entry in the Employer Contact Log captures the date of contact, the name of the person reached, the client the visit was for, and the purpose of the contact. Purposes typically include securing an appointment, learning about the employer’s business, discussing a specific candidate, or maintaining an ongoing relationship. The form also includes a field for what you learned about the employer’s hiring preferences and a “next step” line with a follow-up date. Both the employment specialist and the supervisor sign each entry.1The IPS Employment Center. Sample Employer Contact Log
Write entries the same day as the visit. The details that make the log useful later, such as which hiring manager prefers morning calls or mentioned an upcoming opening, fade fast. Vague entries (“stopped by, talked to manager”) are worse than useless at review time because they create the appearance of activity without any content.
The IPS model’s rapid job search principle sets the pace: the first face-to-face contact with an employer should happen within 30 days of program entry.6IPS Employment Center. What is IPS? The log should start filling up quickly after a client enrolls, and if yours is empty two weeks in, that is the signal to get out of the office.
Storing and Submitting Completed Forms
Completed Career Profiles, Disclosure Worksheets, Employer Contact Logs, and related notes are typically uploaded into the agency’s electronic health record system. Programs that also receive funding through a state vocational rehabilitation agency usually need to submit documentation, often a completed Career Profile and job search plan, to trigger service authorizations or milestone payments. Timelines vary by state, and no uniform federal processing deadline applies to vocational rehabilitation referrals. Check with your state VR office for expected turnaround.
Physical copies of any document containing protected health information must be stored in locked cabinets with access restricted to authorized staff. If a breach of unsecured health information does occur, federal rules require the organization to notify affected individuals within 60 calendar days of discovering the breach.7eCFR. 45 CFR 164.404 – Notification to Individuals Breaches affecting 500 or more people also require notifying the HHS Secretary within that same window. Smaller breaches go into an annual log reported to HHS.
Supervisors should audit documentation on a regular cycle, with monthly a reasonable cadence, to catch missing signatures, incomplete log entries, or stale Career Profiles that no one updated after a job change. These audits also surface job development problems: a specialist with few log entries is probably not spending enough time in the field.
How the Forms Feed Into Fidelity Review
The IPS-25 Fidelity Scale is the 25-item evaluation tool that measures how closely a program follows the IPS model. Items sit in three sections, Staffing, Organization, and Services, each scored 1 to 5, and total scores sort the program into Exemplary Fidelity, Good Fidelity, Fair Fidelity, or Not IPS. Reviewers look at the same forms you are filling out. Employer Contact Logs are the main evidence that a specialist is spending time in the community rather than at a desk, and item 13 requires 65 percent or more of scheduled work hours outside the office for a top score of 5. A specialist with only 30 to 39 percent community time scores a 2.8SAMHSA Library. IPS-25 Fidelity Scale Caseload size also sits in the staffing section, with 20 or fewer clients per specialist earning the top score.9Administration for Children and Families. Individual Placement and Support (IPS) in Practice – Lessons from Breaking Barriers
Sparse or vague logs are one of the most common reasons a program scores poorly. If you fill the forms out the way they were designed to be filled out, with same-day entries, specific detail, and current Career Profiles, the fidelity review takes care of itself.