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University of Massachusetts Dartmouth
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Office of Diversity, Equity & Inclusion
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Please submit separately a physician's (or other appropriate health care provider) letter verifying your disability, explaining in detail the recommended accommodation and how the recommended accommodation is necessary based on your disability. This documentation should be typed or printed on letterhead, dated, signed and legible with the name, title and professional credentials of the evaluator or medical provider.
The ADA Coordinator will review your request, and you will be contacted to discuss your requested accommodation.
The above information is complete and accurate to the best of my knowledge and belief. This information will be maintained confidentially to the extent practicable under the circumstances.
Email: email@example.com - UMass Dartmouth Web Development Team
This page's location: http://www1.umassd.edu/eeo/forms/ada.cfm