Disability Management Services Forms

Form

Description

Campus

Temporary Accommodation Form (webform) This form is used by managers and supervisors to document temporary accommodation.   UC Davis/UC Davis Health
Permanent Accommodation Form (webform) This form is used by managers and supervisors to document a permanent accommodation.   UC Davis/UC Davis Health
Reasonable Accommodation Record of Action Form  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 their position.  See PPSM 81 and UCOP Procedure 81 for further information.  UC Davis/UC Davis Health
Medical Separation Review Form This form is used to initiate a Medical Separation.  Managers and supervisors must contact UC Davis or UC Davis Health DMS  department prior to completing this form. UC Davis/UC Davis Health