Department uses form to begin the Medical Separation process.
Submit to: Disability Management Service

This form is used by both campus and health managers and supervisors to document a permanent accommodation.  Managers & Supervisors using the fillable PDF, submit to: Disability Management Services at melwells@ucdavis.edu.  

For questions on the DocuSign or PDF form please email melwells@ucdavis.edu. 

Here are helpful FAQ's for DocuSign.

Forms:

• DocuSign form
• fillable pdf

This form is used by managers and supervisors to document temporary accommodation.

For questions on the form, please email:
Campus: melwells@ucdavis.edu | Health: kkjlee@ucdavis.edu.

DocuSign FAQ.

Forms:

• Campus DocuSign Form
• Health DocuSign Form
• fillable pdf