Disability Access

If you need assistance with your application, recertification or other program requirements, see below for information and forms you can use to request a Reasonable Accommodation.

Forms

Are You Disabled? Brochure/ ¿Esta Usted Incapacitado (a)? Folleto

  • BRC-681A English (currently being revised)
  • BRC-681A Español (currently being revised)

Request a Reasonable Accommodation/ Peticion de arreglo razonable

HIPAA Authorization/ Autorizacion HIPAA

Request an Appeal of a Reasonable Accommodation Determination/ Petición de Apelación de la Determinación de Arreglo Razonable