BPH 1074 Grievance-Rev 2006 FillablePDF

BPH 1074 REQUEST For REASONABLE ACCOMODATION Rev. 2006 FILLABLE PDF FORM.

Before a BPH hearing you can send this form as soon as possible to the BPH ADA Coordinator in Sacramento or give this form to staff person.

BPH - ADA Coordinator
1515 K Street, Suite 600
Sacramento, CA 95814

If you already had your BPH hearing and you did not like the accomodation you received and want a new hearing, then fill out Section C, on page 2 of the form.