Reasonable Accommodation Request Form
Overview of this form
The Reasonable Accommodation Request Form is designed to help employers assess the need for adjustments in the workplace for employees with disabilities. This form clarifies what accommodations are required to enable individuals to perform essential job functions effectively. Unlike other employment forms, this one specifically focuses on ensuring compliance with disability rights and providing necessary support to disabled employees.
Key parts of this document
- Employee Information: Areas for the employee to provide personal details and request for accommodations.
- Essential Job Function Analysis: A section assessing the jobâs essential functions to determine relevant accommodations.
- Health Care Professional Documentation: A requirement for medical validation of the employee's disability when necessary.
- Human Resources Review: A structured process for HR to evaluate and respond to the accommodation request.
- Confidentiality Clause: Instruction on how to handle the form separately from personnel records to protect employee privacy.
Situations where this form applies
Use the Reasonable Accommodation Request Form when an employee with a disability requests changes or adjustments in their work environment. This may include modifications to their workspace, adjustments to work schedules, or other changes necessary for them to perform their job duties safely and effectively. This form is essential for ensuring equal opportunity and compliance with workplace laws.
Intended users of this form
- Employees with disabilities seeking reasonable accommodations to perform their jobs.
- Employers or HR personnel responsible for managing accommodation requests and ensuring legal compliance.
- Health care professionals providing documentation or recommendations regarding an employee's disability.
Completing this form step by step
- Step 1: The employee fills out Section I, stating their request for accommodation and any relevant details.
- Step 2: Ensure a signed Health Care Professional Release Form is included if medical validation is needed.
- Step 3: Complete the Essential Job Function Analysis to determine necessary adjustments.
- Step 4: Submit the signed Reasonable Accommodation Request Form, Essential Job Function Analysis, and current job description to Human Resources.
- Step 5: HR reviews the submission and engages with health care professionals if additional documentation is requested.
Does this form need to be notarized?
Notarization is not commonly needed for this form. However, certain documents or local rules may make it necessary. Our notarization service, powered by Notarize, allows you to finalize it securely online anytime, day or night.
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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.
Avoid these common issues
- Neglecting to keep the form confidential, which could breach employee privacy.
- Failing to complete the Essential Job Function Analysis before submitting the request.
- Not obtaining the necessary signatures or documentation from health care professionals.
- Submitting the form to the wrong department or failing to follow up on the request.
Benefits of using this form online
- Convenience: Access and complete the form from anywhere, at any time.
- Editability: Easily modify the form as necessary when circumstances change.
- Reliability: Download forms that are legally vetted and up-to-date with current laws.
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FAQ
Dear So-and-So, I am writing to request a reasonable accommodation as a person with disabilities. I am requesting this accommodation so that I will have equal opportunity to participate in your housing.
Your name and position. The date. Information about your disability. A request for accommodation. Accommodation ideas. Medical information.
____________________________________________________________________ Provide the name, address, telephone and fax numbers of your health care provider. The provider may receive a request from us for information regarding your impairment/disability and recommendations for accommodations.
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. Request your employer's accommodation ideas.
A reasonable accommodation is any change to the application or hiring process, to the job, to the way the job is done, or the work environment that allows a person with a disability who is qualified for the job to perform the essential functions of that job and enjoy equal employment opportunities.
Providing an assistant as needed may be a reasonable accommodation for a person with a disability, if this does not impose an undue hardship. Examples include: An assistant may be needed to retrieve items on shelves, file, or selectively assist a person with quadriplegia with other clerical duties.
Your name and position. The date. Information about your disability. A request for accommodation. Accommodation ideas. Medical information.
Step One: Determine whether an individual has a disability and meets minimum qualification standards. Step Two: Determine the essential functions of the job. Step Three: Identify the abilities and limitations of the individual. Step Four: Identify potential accommodations.
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.