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U.S. Department of StateMEDICAL QUESTIONNAIRE FOR ASSESSMENT OF DISABILITY/REASONABLE ACCOMMODATION For the Employee (a) Release of Information Please sign and date the authorization printed below.

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How to fill out the DoS DS-6546 online

The DoS DS-6546 is a medical questionnaire designed for assessing disability and reasonable accommodation requests. This guide provides clear, step-by-step instructions for completing the form online, ensuring users understand each section and field as they navigate the process.

Follow the steps to successfully complete the DoS DS-6546 online:

  1. Click the ‘Get Form’ button to access the online version of the DoS DS-6546 and open it in your preferred editor.
  2. Begin by reviewing the release of information section. This section requires you to provide your signed authorization allowing your physician to share your medical information with the Department of State.
  3. Carefully fill in the employee's personal details, including your name, employee ID number, home address, city, state, ZIP code, as well as your work and home phone numbers and email address.
  4. Prepare your Employee Statement on a separate sheet of paper. This should detail your specific job limitations that necessitate an accommodation, as well as any medical reasons supporting your request.
  5. Advise your physician to complete the section tailored for them. This includes providing details about your medical diagnosis, current medications, and the extent to which your condition affects your work.
  6. Ensure your physician reviews the Work Requirements Statement and attaches their assessment of your medical condition regarding your ability to perform various work activities.
  7. Upon completion, check all fields for accuracy. You can then choose to save your changes, download the form, print it, or share it as required.

Complete your documentation online to ensure your requests are processed efficiently.

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: something supplied for convenience or to satisfy a need: such as. a. : lodging, food, and services or traveling space and related services. usually used in plural. tourist accommodations on the boat.

Accommodation: In medicine, the ability of the eye to change its focus from distant to near objects (and vice versa). This process is achieved by the lens changing its shape.

Reasonable accommodation can include, but is not limited to, the following: Changing job duties. Providing leave for medical care. Changing work schedules.

1. Adjustment or adaptation. 2. The adjustment of the eye for various distances whereby it is able to focus the image of an object on the retina by changing the curvature of the lens.

Accommodations are typically grouped into four categories: presentation, response, setting, and timing and scheduling.

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