Get the free Physical Impairments Notification Form 111208

Physical Impairments Notification Form Pursuant to California Code of Regulations, Title 19, Section 3.09 ×d× 5 ×b), Citigroup Centers Office of the Building is required to maintain information

How to fill out physical impairments notification form

How to fill out physical impairments notification form:

1. Start by carefully reading the instructions provided on the form. Make sure you understand what information is required and how to accurately complete each section.
2. Begin by filling out your personal information, such as your full name, address, phone number, and email address. Provide any other requested contact details.
3. Next, indicate the type of physical impairment you have by selecting the appropriate option from the provided choices. If your specific impairment is not listed, there may be a section to provide additional details.
4. Describe any accommodations you require due to your physical impairment. This may include assistive devices you use, modifications needed in your work or living environment, or any other support you need.
5. Specify any medical professionals or specialists you have consulted regarding your physical impairment. Provide their names, addresses, and phone numbers if requested.
6. If applicable, provide any relevant medical documentation or reports that support your physical impairment and the need for accommodations. This may include doctor's notes, test results, or treatment plans.
7. Lastly, carefully review your completed form to ensure all information is accurate and complete. Sign and date the form as required.

Who needs physical impairments notification form:

1. Individuals with physical impairments who require accommodations in various settings, such as at work, school, or public facilities.
2. Employers or institutions that need to be informed of an individual's physical impairment in order to provide reasonable accommodations and ensure equal opportunities.
3. Medical professionals or specialists who need to document and communicate a patient's physical impairment and any necessary accommodations for proper care and treatment.

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