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Sample Letter – Request to Change Counselor

Client Assistance Program & Vocational Rehabilitation

[Insert Date]

[Insert Name of your VR Counselor’s Supervisor]
Vocational Rehabilitation Services
[Insert VR Address]


Re: Request to Change Counselor

Dear Mr./Ms. [Insert Name of Counselor’s Supervisor]:

Please accept this letter as my request for a transfer of Vocational Rehabilitation Counselors. Although I appreciate the assistance I have received from your office, My relationship with my current Counselor, [insert VR counselor’s name] is irreparable and can no longer continue working with this counselor.

Please provide your answer to my request in writing. If you disagree with my request, please provide me with my appeal rights on this matter.



[Insert Your Name]
[Insert Your Address]
[Insert Your Telephone Number]
Sign and mail the original letter and keep a copy for your records.

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