Breadcrumb
SPF Job Duty Evaluation Checklist
Form:
Document
spfjobdutyevaluationchecklist.pdf (353.24 KB)
Department: Research
Routing Instructions:
Instructions: Employee/applicant shall contact the treating health care provider to complete this form. Employee/ applicant should return the completed form to ADA coordinator at Cal Poly Humboldt Human Resources. If you have any questions, please contact the ADA Coordinator, at 707.826.3626, or confidential fax 707.826.3625. A carbon copy, photocopy, or facsimile copy of this true medical release shall be as valid as an original of same. For telecommunications needs, please use the California Relay Service at 877.735.2929 TTY. To: Re:
Category:
Employee
Faculty
MPP
New employee
Staff
Student