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The purpose of this form is to assist the Disability Resource Center (DRC) in determining whether, or to what extent, a reasonable accommodation is required for a disabled or pregnant employee with a disability to perform the essential functions of his/her job safely and effectively.
This form will be treated confidentially and filed at the DRC. It will be maintained separately from any personnel records.
You should receive an immediate email confirmation from Arizona.DRC@accessiblelearning.com, acknowledging the receipt of your application. Please contact drc-workplaceaccess@email.arizona.edu if you have any questions regarding this process or have not been contacted within 72 hours of submission.
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