DSPS - Communication Services Form (Faculty/Staff Request)

This form is for faculty and staff of Cerritos College that need to request communication services for a deaf/hard-of-hearing person to participate in a campus activity such as a counseling appointment, job interview, or class activity.  

Please fill out this form completely.  Each request must be filled-out separately (only one request per form).


Please select  the appropriate service.


Please select the communication preference




Please fill in ALL information in this section.

Select the appropriate day service will be needed or canceled 






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