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Date: 2016-02-16 16:41:10 | 100 Disability Services, Irvine, CA, 3083 fax Verification of Medical/Physical/Perceptual Impairment Student Name (Please PRINT clearly) _______________________________________ Birthdate _Add to Reading ListSource URL: disability.uci.eduDownload Document from Source WebsiteFile Size: 378,28 KBShare Document on Facebook |