Documentation is considered a confidential student record protected under all applicable state and federal privacy laws.
Please provide the following information:
1. Student's Name;
2. Date of Birth;
3. Printed Name and Signature of Certifying Professional;
4. License Number;
5. Business Address;
6. Business Phone Number; and
7. Business Fax number
Documentation should include:
1. Clear, concise description of hearing impairment (i.e., severity, date of onset);
2. Functional limitations as they pertain to an academic environment;
3. A copy of the most recent audiogram; and
4. Suggested accommodations.
All documentation is confidential and should be submitted to:
UC Merced Student Accessibility Services
5200 N. Lake Rd., ACS 140
Merced, CA 95343
Phone: 209-228-6996
Fax: 209-228-4661
