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Community Rehabilitation Program Application Form - Utah State Office Of Rehabilitation Page 6

ACCESSIBILITY ASSURANCE

Federal Law Rules and Regulations (PL 84-142. 34c FR 361.45) states:

A state unit must assure that any Rehabilitation Facility to be utilized in the provision of vocational

rehabilitation services must comply with the requirements of the Architectural Barriers Act of 1968,

and the Americans with Disabilities Act architectural guidelines for making buildings and facilities

accessible to and usable by the physically handicapped.

Yes

the facility is accessible to individuals with disabilities.

If necessary will you provide your service in an alternative way to ensure that your services are

accessible to person with disabilities?

Yes

Americans with Disabilities Act (ADA), Regulation 36.303 Auxiliary

Aids and Services states:

A public accommodation shall take those steps that may be necessary to ensure that no individual

with a disability is excluded, denied services, segregated or otherwise treated differently than other

individuals because of the absence of auxiliary aids and services, unless the public accommodation

can demonstrate that taking those steps would fundamentally alter the nature of the goods, services,

facilities, privileges, advantages, or accommodations being offered or would result in an undue

burden, i.e., significant difficulty or expense.

Yes

the CRP is willing to take the necessary steps to provide auxiliary aids

and services in order to ensure that no individual with a disability is excluded, denied services, or

segregated unless the facility can demonstrate that provision of these aids and assistance would

fundamentally alter the nature of services or result in undue burden.

Date

Authorized Official

Name of Applicant

Street Address

City, State, Zip

Community Rehabilitation Program Application Form - Utah State Office Of Rehabilitation Page 6