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Click ‘Get Form’ to open the medical questionnaire accommodation in the editor.
Begin by entering the employee's name, UIN, job title, and department in the designated fields. Ensure no abbreviations are used for clarity.
In section A, answer questions regarding the employee's physical or mental impairments. Be specific about the impairment and its duration.
Continue with section B by detailing any limitations that may interfere with job performance. Clearly describe how these limitations affect essential job functions.
In section C, provide suggestions for reasonable accommodations that could assist the employee in meeting job requirements. Explain how these accommodations would be beneficial.
Finally, ensure all fields are completed accurately before submitting the form to the Employee Relations Department via email or fax.

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What are the 5 common means of reasonable accommodation?

Commonly Utilized Accommodations Electronic copies of notes, handouts, overheads, or chalkboard notes. Use of a scribe or note taker. Seating locations (close to the chalkboard or screen) Tape-recorded lectures. Taped textbooks. Alternate test format: oral, Braille, or large print.

What are the medical questions for reasonable accommodation?

Under the ADA, in response to an accommodation request, an employer may ask what impairment is involved, why medication is needed, and its impact on job performance.

What are examples of medical accommodations?

Examples of reasonable accommodations include providing interpreters, readers, or other personal assistance; modifying job duties; restructuring work sites; providing flexible work schedules or work sites (i.e. telework) and providing accessible technology or other workplace adaptive equipment.

What are the most common accommodations?

An individual meets the Americans with Disabilities with Act definition act of disability that would qualify them for reasonable accommodations if they have a physical or mental impairment that substantially limits one or more major life activities (sometimes referred to in the regulations as an actual disability)