PDF ADA Request for Accommodations Form.pdf - The University of ... 2026

1. Click ‘Get Form’ to open the PDF ADA Request for Accommodations Form in the editor.
2. Begin by entering the patient's or employee's name in the designated field at the top of the form.
3. Fill in the date on which you are completing the form. This is crucial for record-keeping.
4. Answer the questions regarding disability verification carefully, selecting 'Yes' or 'No' as applicable.
5. In the section about major life activities, check all that apply to ensure a comprehensive understanding of limitations.
6. Provide detailed information about specific functional limitations and their durations in the provided chart.
7. Complete the medical provider information section, ensuring all fields are filled accurately before submission.
8. Once completed, save your changes and return this form to Human Resources via email or physical address as indicated.

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