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Alternate Communications Request Form Pt. Name: Address: City State Zip MAN: DOB: SEX: DOS: Request for Alternate Communications Regarding Medical Information Date: Month / Date / Year I wish to request

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What is alternate communications - utsouthwestern?

Alternate communications - utsouthwestern refers to the process of providing communication assistance to individuals with disabilities who require accommodations to effectively communicate with personnel at UT Southwestern Medical Center.

Who is required to file alternate communications - utsouthwestern?

Any individual with a disability who requires alternate communications to interact with UT Southwestern Medical Center personnel is required to file for alternate communications.

How to fill out alternate communications - utsouthwestern?

To fill out alternate communications at UT Southwestern, individuals can contact the Disability Services Office to request accommodations and assistance with communication needs.

What is the purpose of alternate communications - utsouthwestern?

The purpose of alternate communications at UT Southwestern is to ensure that individuals with disabilities have equal access to information and services provided by the medical center.

What information must be reported on alternate communications - utsouthwestern?

The information reported on alternate communications at UT Southwestern may include the type of disability, specific communication needs, preferred method of communication, and any requested accommodations.

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