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Disability Determination

1. My emotional disability is evidenced by the following:

2. Check if any of these impairments (listed above) impact one or more major life activities, such as:

Air Carrier and Access Act/14 CFR, Part 382

Fair Housing Act

Appropriateness/Efficacy of ESA, Informed Consent

My Pet Information

Please enter your card number.
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Please enter your card expiry date.
Please enter your card security code (CVV/CVC).