Hawaii Reasonable Accommodation Request Form

Category:

Employment - Personnel Files

State:

Multi-State

Control #:

US-216EM

Format:

Instant download

Description

This form may be used to assist a company in determining to what extent a reasonable accommodation is required.

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FAQ

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.

Respected Sir/Madam, I wrote this letter to you to request for accommodation for the month (Explain your requirement). I am (Job designation, e.g., security office ay night shift), having no relatives whatsoever in (Area name), and staying in the hostel far away. (Describe in your own words).

What to Include in Your Reasonable Accommodation LetterYour name and position.The date.Information about your disability.A request for accommodation.Accommodation ideas.Medical information.

I request you to kindly give me accommodation. It is very hard for me to stay in hotels or hostels. (Cordially describe your requirements). I shall be really thankful to you if you provide me accommodation considering my issue.

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.

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.

Steps for Requesting AccommodationsComplete a Getting Started Form. This basic form consists of contact information and five brief questions.Provide DSS with current disability related documentation.Meet with DSS for an intake appointment.Request Your Accommodations Each Term.

In your reasonable accommodation letter, you should provide all the information your employer will need to begin the accommodation process, including what your disability is, how it affects you, which aspects of your job might require modification, and proposed accommodations.

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...