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DMS Reasonable Accommodation Record of Action

A department uses this form to document efforts made to reasonably accommodate an employee who becomes disabled and needs assistance to perform the essential functions of his or her position. See PPSM 81 and UCD Procedure 81 for further information.

Disability Management Services Reasonable Accommodation Record of Action - Online Form

You may also download the Reasonable Accommodation Record of Action Form as a Word document.

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