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St. Cloud State University ADA Authorization for Release of Medical Information TO: Name of Medical Provider Address City State Zip Code RE: Name of Patient Birthdate or SSN.

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Dear [Employee name]: On [date], you informed [name and title] of your medical condition and requested a job accommodation to be able to perform your job functions. [Company Name] complies with the Americans with Disabilities Act (ADA), and we want to support you in continuing to perform your job duties.

Reasonable accommodations for anxiety can include remote work, a support animal, a rest area, a modified break schedule, a flexible schedule, and shifts in schedule. The type of anxiety you have, your limitations, and your employer's resources will determine what accommodation is appropriate.

Examples of accommodations include: sign language interpreters for students who are deaf; computer text-to-speech computer-based systems for students with visual impairments or Dyslexia; extended time for students with fine motor limitations, visual impairments, or learning disabilities;

Examples of workplace accommodations for migraine include flexible scheduling, teleworking capabilities, and measures to help reduce excessive sound and light.

Examples of such accommodations include: Flexible scheduling to allow time for counseling and appointments. Allowing calls to medical providers during work hours. More frequent breaks and backup coverage as needed.

I work at ________(Company Name) as a ________(Your Job Title) and have been in this position since ____ (Date). I am writing to request that you provide __________________(list accommodation needed here) as a reasonable accommodation under the ADA.

What types of accommodations are generally considered reasonable? Change job tasks. Provide reserved parking. Improve accessibility in a work area. Change the presentation of tests and training materials. Provide or adjust a product, equipment, or software. Allow a flexible work schedule.

The ADA prohibits discrimination based on disability. Under the ADA, it is illegal to discriminate against someone because of their disability. For example, a fitness center could not exclude a person who uses a wheelchair from a workout class because they cannot do all of the exercises in the same way.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232