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  • American Disability Act Accommodation Request Form ...

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Dance with the Americans with Disability Act (ADA). Name Date of Request Campus Address Campus Phone Number Department Classification/Position Title Please answer the following questions to assist the agency in understanding the basis and nature of your request for accommodation. The information you provide will be treated confidentially and will be handled on a need-to-know basis. What are the essential duties and responsibilities of the position which will be or are affected by your disab.

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How to fill out the American Disability Act Accommodation Request Form online

Completing the American Disability Act Accommodation Request Form is an important step in requesting necessary accommodations. This guide will provide you with a clear and supportive approach to filling out the form online, ensuring that your needs are accurately communicated.

Follow the steps to complete your accommodation request.

  1. Click ‘Get Form’ button to access the accommodation request form and open it in your editor.
  2. In the first section labeled 'Employee Request', enter your full name, the date of your request, your campus address, campus phone number, and department. Make sure all information is accurate for effective processing.
  3. Under 'Classification/Position Title', specify your job title. This helps clarify the context of your request.
  4. Answer the essential duties and responsibilities question thoroughly. Describe how your disability may affect your ability to perform your job tasks.
  5. In the next field, detail the specific duties that are impeded due to your condition. Your insights are crucial for understanding the impact of your disability.
  6. Describe the type of accommodation you believe would best enable you to participate in your program or activity. Be as specific as possible to assist in finding the best solution.
  7. Indicate whether you can perform all essential job functions with the requested accommodations. If not, note the specific functions that may remain challenging.
  8. Provide any additional information that may aid the agency in determining suitable accommodations, ensuring that you include any relevant details.
  9. Once you have completed all fields, ensure your supervisor has the opportunity to review and add their comments or recommendations.
  10. Finalize your request by signing and dating the form, and ensure your supervisor also signs it. If possible, submit the form directly by clicking submit or have your supervisor forward it via email.

Begin your request for accommodations online today.

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[Example 1] As a result of [Name]'s disability, she occasionally experiences episodes of disorientation and dizziness. During these episodes, [Name] must sit or lie down for a few minutes to recover. Therefore, [Name] needs, as an accommodation, permission to take these short breaks.

[Example 1] As a result of [Name]'s disability, she occasionally experiences episodes of disorientation and dizziness. During these episodes, [Name] must sit or lie down for a few minutes to recover. Therefore, [Name] needs, as an accommodation, permission to take these short breaks.

The Accommodation Form serves as the official notification to your instructors regarding your approved accommodations.

Dear [Insert employer's name here]: I am writing this letter to submit a request for accommodations in the workplace. I have pain in my lower back. Sitting or standing for long periods of time in the same position is causing increased pain and is decreasing my mobility.

Content to consider in body of 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.

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.

Change job tasks. Provide reserved parking. Improve accessibility in a work area. Change the presentation of tests and training materials.

Content to consider in body of 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.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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