Americans with Disabilities Act (ADA)

Americans with Disabilities Act Request Form

Completed request and health provider certification forms must be submitted directly to Employee Health Services only to protect employee information and privacy. Completed forms may be submitted via fax at 313-748-6119 (preferably) or emailed to dps.ehs@detroitk12.org.

Do not submit medical forms to supervisors, managers, or clerical staff. These individuals are not authorized to receive or store confidential medical information. If you have questions about what documentation is required or how to submit your forms, please contact the EHS team.

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ADA Health Provider Certification Form 

In addition to the above form, before a request for reasonable accommodation can be evaluated for approval, a complete and sufficient ADA Health Care Provider Certification Form must be received.  Failure to submit a complete and sufficient certification may delay or cause your request for accommodation to be denied.

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