Fair Hearing Forms and Related Documents

Fair Hearing Forms are available for downloading and printing (see below) on this Web site or you can request them from local DOR staff.

For more information about the accessible PDF documents on this website, please view our "About PDF" page.

Request for Mediation and/or Fair Hearing Form (DR 107):

 

Authorized Representative Form (DR 108):

 

Send completed, signed forms by mail, fax, or email to:

Mediation and Fair Hearing Office
c/o Department of Rehabilitation
Legal Affairs
P.O. Box 944222
Sacramento, CA 94244-2220
Fax: (916) 558-5861
appealsinfo@dor.ca.gov

Please call (916) 558-5860 to arrange for hand delivery to:

Mediation and Fair Hearing Office
c/o Department of Rehabilitation
Legal Affairs
721 Capitol Mall
Sacramento, CA 95814

 

Related Documents:

Rights and Remedies Attachment (DR 1000)

 

Fair Hearing Process Information

Appeals Links

Appeals Forms

Related Documents

Contact Information

Mediation and Fair Hearing Office
c/o Department of Rehabilitation
Legal Affairs
P. O. Box 944222
Sacramento, CA 94244-2220

Voice: (916) 558-5860
TTY: (916) 558-5862
Fax: (916) 558-5861
appealsinfo@dor.ca.gov