Florida ADA Medical Documentation for Use by Medical Practitioner

State:
Multi-State
Control #:
US-AHI-209
Format:
Word
Instant download

Description

This AHI form is to be used by an employer who has hired a disabled employee. This form must be sent to the employees medical physician. This from includes the employees job description and functions preformed by the employee.
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How to fill out ADA Medical Documentation For Use By Medical Practitioner?

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FAQ

A completed Special Accommodation Request Packet includes the Candidate ADA Request Form, the Professional Accommodation Verification Form and any additional information or documentation requested by PCS to evaluate an accommodation request.

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.

According to the EEOC, you only have to let your employer know that you need an adjustment or change at work for a reason related to a medical condition. You can use "plain English" to make your request and you do not have to mention the ADA or use the phrase "reasonable accommodation."

Under the ADA , you have a disability if you have a physical or mental impairment that substantially limits a major life activity. The ADA also protects you if you have a history of such a disability, or if an employer believes that you have such a disability, even if you don't.

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.More items...

Sample Accommodation Request LetterIdentify 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.More items...

How To Request AccommodationsKeep it simple. You can tell your employer that you need an adjustment or change because of a medical condition.Put it in writing.Talk to the right people.How it works: an example.Finding help.19-Jul-2018

Examples of Reasonable AccommodationsAcquiring or modifying equipment or devices such as adjusting a desk height to accommodate an employee who uses a wheelchair or providing an employee with quadriplegia a mouth stick device to type on their computer.

I have been working in (Branch) since (Duration) holding employee ID (Employee ID). Through this letter, I would request you to kindly provide me with accommodation. I, on // (Date) got transferred to (Branch Address) branch and have no place to reside at.

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Florida ADA Medical Documentation for Use by Medical Practitioner