- Health Care Provider Form (fillable form)
- Request for Reasonable Accommodation (fillable form)
- UNH Exception to USNH Travel Policy Request Form
To complete a fillable form:
- Open the form.
- Click on "open with different viewer" (located in upper right hand corner of the screen) and then "OK" This will highlight the fillable sections of the form. Note: this may save to your downloads arrow.
- Select "Open with Adobe Acrobat 8.0” or “save” the form first to your computer (default).
- Complete the form and save. Print the Healthcare Provider Release Form to sign the document. Original signature is needed.
- Return forms to the EEO/ADA Compliance Officer, Affirmative Action and Equity office, 105 Main Street, Thompson Hall 305, Durham, NH or fax to (603) 862-2936.
- The accommodation request documents contain protected medical information – do not email.
Please contact Gail Dixon-McMahon if you have any technical difficulties. You can certainly just print the form and fill it out by hand.