Breadcrumb
Forms: ADA Forms for Employees
| Form/Agreement | Link |
|---|---|
| Accommodation Request Form (Employee) | Employee Accommodation Request Form |
| ADA Medical Certification Form (Employee) | Employee ADA Medical Certification Form |
| Authorization to Release Confidential Medical Records of Information | Authorization to Release Confidential Medical Records or Information |
| Emotional Support Animal Verification Form (Employee) | Employee Emotional Support Animal Verification Form |
| Accommodations Appeal Form (Employee) | Employee Accommodations Appeal Form |
NOTE REGARDING THE ADA MEDICAL CERTIFICATION FORM: Employee/applicant shall contact the treating health care provider to complete the Employee ADA Medical Certification Form. Employee/applicant should return the completed form to the ADA/504 Coordinator at the Cal Poly Humboldt Campus Disability Resource Center. Any form completed by the employee, or for which incomplete information is noted, will not be accepted.