SOP 103.63-att-2: Warden's_Superintendent's ADA Accommodation Request Response

SOP 103.63
Attachment 2

4/20/18

WARDEN’S/SUPERINTENDENT’S ADA ACCOMMODATION REQUEST RESPONSE

Offender's Name: ADA REQUEST #:

GDC #: Facility:

RESPONSE TO ADA ACCOMMODATION REQUEST:

Warden’s/Superintendent’s Signature (Date)

I ACKNOWLEDGE RECEIPT OF THE ABOVE RESPONSE ON THIS DATE:

Offender’s Signature (Date)

_You have seven (7) calendar days to appeal a denial of an ADA accommodation (s) to the Commissioner’s Designee at_
_P.O. Box 1529 Forsyth, Georgia 31029._

Retention Schedule: Upon completion, the original of this attachment shall be placed in the offender’s institutional file
and retained according to the official retention schedule for this file. A copy of this attachment shall be placed in the
medical file and mental health file, as necessary, and retained according to the official retention schedule for that file. A
copy of this attachment shall also be maintained in the Facility ADA Coordinator’s and Agency’s ADA Coordinator’s
offices for four (4) years following the final decision of the request.