Please complete the forms below to register with the EARC. Be sure to refer to the EARC Prospective Employee Registration Checklist (PDF) for a detailed guide to the EARC employee registration and employment accommodation request process.
Note: If your only request is for disabled parking, please complete forms listed below under the "Disabled Parking Request Forms" section. If you are requesting disabled parking as well as other accommodations, please complete the forms listed in the "Registration Forms" section directly below.
EARC Intake Form (PDF) -to be completed by employee requesting employment accommodations.
EARC Medical/Psychological Disability Verification Form (PDF) -to be completed by appropriate professional.
Registered Employee Forms
The following employment accommodation request form is to be used by employees who: (1) are currently registered with the EARC; (2) are requesting continued and/or additional employment accommodations for an exisiting condition(s) currently registered with the EARC; and (3) have previously prescribed employment accommodations by EARC for existing condition(s) currently registered with EARC.
Note: An employee registered with the EARC has provided the EARC with medical/psychological disability verification that qualifies him/her as an individual with a disability under FEHA and/or ADA, as amended.
EARC Employment Accommodations Request Form (PDF) - to be completed by the employee requesting employment accommodations.