Forms hr

ADA Reasonable Accommodation Request

ADA Title I accommodation request — initiates interactive process per EEOC.

Built for: All

What's inside this template

What functions / job duties are difficult to perform? (required)
What accommodation are you requesting? (required)
Be specific — e.g., raised desk, schedule modification, screen reader, etc.
When did you become aware of the need?

Healthcare provider statement attached?
May be required for non-obvious disabilities
Healthcare provider documentation

Disability accommodation request

Interactive process initiation

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