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  • (ada) Employee Accommodation Request Form - Bc3

Get (ada) Employee Accommodation Request Form - Bc3

HR Revised 8/10/10 Americans with Disabilities Act (ADA) Employee Accommodation Request Form Employee s Name: Date: Position: 1. Describe how your condition affects your ability to perform a major.

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Dear Mr./Ms. (Contact at Human Resources Department): 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.

Dear Mr./Ms. (Contact at Human Resources Department): 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.

Request Confirmation Form (DI-6513): The Request Confirmation Form must be completed by any agency officials when a verbal request for accommodation is made. This form documents the receipt of a verbal request for record-keeping purposes and should be provided to the servicing Human Resources Office (SHRO).

Providing an assistant as needed may be a reasonable accommodation for a person with a disability, if this does not impose an undue hardship. Examples include: An assistant may be needed to retrieve items on shelves, file, or selectively assist a person with quadriplegia with other clerical duties.

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.

I learned in our conversation on [date], that you have a health condition that may impact your ability to perform your job. I want you to have the opportunity to be successful in your job and encourage you to work with us in identifying reasonable accommodation, if needed, which will provide this opportunity.

Sample Accommodation Request Letter Identify yourself as a person with a disability. State that you are requesting accommodations under the ADA (or the Rehabilitation Act of 1973 if you are a federal employee) Identify your specific problematic job tasks. Identify your accommodation ideas.

A letter of accommodation (LOA) is a plan for academic accommodations. Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 protect students from discrimination based on disability and assure students the right to reasonable accommodations.

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© Copyright 1997-2025
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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