Medical Accommodations Request Form 2022-23. Americans with disabilities citizens and consumers. Submit the completed medical accommodations request form to your school’s 504 coordinator, along with
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Request for reasonable accommodation form #: Web how to request health services educational and other accommodations paraprofessionals transportation accommodations frequently asked questions parent communications medically necessary instruction summary section 504 of the rehabilitation act of 1973 requires public schools to offer accommodations for eligible. ☐ acute ☐ chronic expected duration of accommodation: Part i—requester’s contact information requester’s name: Web if the request is for a diagnosis of allergies/anaphylaxis, diabetes, or seizure disorder, please complete the medical accommodations request form addendum. Please return this form to the employee or directly to the agency within 15 days of receipt. Download adobe reader ™ print page email page last reviewed: Please attach additional documentation, if needed student name: Americans with disabilities citizens and consumers. Hrm 2300.1 pdf versions of forms use adobe reader ™.
☐ acute ☐ chronic expected duration of accommodation: Request for reasonable accommodation form #: Americans with disabilities citizens and consumers. Date of medical documentation request: Save or instantly send your ready documents. Submit the completed medical accommodations request form to your school’s 504 coordinator, along with Please return this form to the employee or directly to the agency within 15 days of receipt. Download adobe reader ™ print page email page last reviewed: Easily fill out pdf blank, edit, and sign them. Hrm 2300.1 pdf versions of forms use adobe reader ™. ☐ acute ☐ chronic expected duration of accommodation:
