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CSUDH Physicians ADA Job Accommodation Request Disability Verification 2022-2025 free printable template

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1000 East Victoria Street, WH 340 PHONE: (310) 2433771 Carson, California 90747 FAX: (310) 9287256PHYSICIANS ADA JOB ACCOMMODATION REQUEST DISABILITY VERIFICATION FORM NAME OF PATIENT/EMPLOYEE: ___DATE:
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CSUDH Physicians ADA Job Accommodation Request Disability Verification Form Versions

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How to fill out CSUDH Physicians ADA Job Accommodation Request Disability

01
Download the CSUDH Physicians ADA Job Accommodation Request Disability form from the official website.
02
Read the instructions carefully to understand the requirements.
03
Fill out your personal information at the top of the form, including your name, contact information, and job title.
04
Provide details about your disability and how it affects your job performance.
05
Specify the type of accommodation you are requesting and explain why it is necessary.
06
Include any supporting documentation from a healthcare provider if required.
07
Review your form for accuracy and completeness before submitting.
08
Submit the completed form to the designated HR representative or office as instructed.

Who needs CSUDH Physicians ADA Job Accommodation Request Disability?

01
Employees of CSUDH who have disabilities and require accommodations to perform their job duties effectively.
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CSUDH Physicians ADA Job Accommodation Request Disability is a formal process allowing employees to request accommodations for disabilities covered under the Americans with Disabilities Act (ADA) to ensure they can perform their job functions effectively.
Employees who have a disability as defined by the ADA and require reasonable accommodations to perform their essential job functions are required to file the CSUDH Physicians ADA Job Accommodation Request Disability.
To fill out the CSUDH Physicians ADA Job Accommodation Request Disability, an employee must complete the request form, providing necessary personal details, a description of their disability, the specific accommodations needed, and any supporting documentation from a healthcare professional.
The purpose of the CSUDH Physicians ADA Job Accommodation Request Disability is to facilitate the process of obtaining necessary accommodations for employees with disabilities, promoting an inclusive work environment and ensuring compliance with ADA regulations.
The information that must be reported includes the employee's name, contact information, a description of the disability, details of the requested accommodations, and any relevant medical documentation supporting the request.
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