Washington ADA Questionnaire for Physician

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State:
Multi-State
Control #:
US-250EM
Format:
Word; 
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Description

This questionnaire allows an employer to ascertain if an employee suffers from a disability under the ADA in order to make a reasonable accommodation.
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  • Preview ADA Questionnaire for Physician
  • Preview ADA Questionnaire for Physician
  • Preview ADA Questionnaire for Physician
  • Preview ADA Questionnaire for Physician
  • Preview ADA Questionnaire for Physician
  • Preview ADA Questionnaire for Physician

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FAQ

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...

Title I (Employment) Equal Employment Opportunity for Individuals with Disabilities.Title II (State and Local Government) Nondiscrimination on the Basis of Disability in State and Local Government Services.Title III (Public Accommodations)

This questionnaire is part of an interactive process that is necessary in order to determine if your patient (our employee) has a disability recognized under the Americans With Disabilities Act, and, if so, what, if any, reasonable accommodation(s) are necessary and can be made that would enable your patient to perform

Titles of the ADATitle Iemployment.Title IIpublic entities (and public transportation)Title IIIpublic accommodations (and commercial facilities)Title IVtelecommunications.Title V miscellaneous provisions.

Top ADA Frequently Asked QuestionsWhat is the definition of disability under the ADA?What is considered an "undue hardship" for a reasonable accommodation?Is my building "grandfathered in" under the older ADA Standards or do I need to comply with the new 2010 ADA Standards for Accessible Design?More items...

The ADA requires employers to treat any medical information obtained from a disability-related inquiry or medical examination (including medical information from voluntary health or wellness programs (9)), as well as any medical information voluntarily disclosed by an employee, as a confidential medical record.

The ADA is divided into five titles:Employment (Title I)Public Services (Title II)Public Accommodations (Title III)Telecommunications (Title IV)Miscellaneous (Title V)

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.

Have an equal opportunity to be promoted once they are working; have equal access to benefits and privileges of employment that are offered to other employees, such as employer-provided health insurance or training; and. must not be harassed because of their disability.

How to Handle an Employee's Request for an ADA AccommodationStep 1: Determine Whether the Employer Is Covered by the ADA.Step 2: Ensure a Policy and Procedure Exist for Handling Accommodation Requests.Step 3: Determine Whether the Employee with a Disability Is "Qualified"Step 4: Initiate the Interactive Process.More items...

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Washington ADA Questionnaire for Physician