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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
Whether for commercial reasons or personal matters, everyone must confront legal issues at some point in their life.
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Dear [Insert employer's name here]: I have been having medical issues that have affected my mood, sleep schedule, concentration, and focus. I would like to request accommodations so that I might be able to perform my job effectively before my performance starts to suffer.
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.
I am experiencing the following difficulties in performing my job because of my disability: _______________________. I am writing to request that you ______________________ (state requested accommodation) because it will___________________________ (how it will help you do your job) as a reasonable accommodation.
[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.
I am writing to request permission to telework as a reasonable accommodation under the ADA. As you may know, I have a disability (you may list your disability here or wait for your employer to request documentation of your disability) and this accommodation would help me be successful at my job.