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Content to consider in body of letter: 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.
Examples of Reasonable Accommodations Acquiring or modifying equipment or devices such as adjusting a desk height to accommodate an employee who uses a wheelchair or providing an employee with quadriplegia a mouth stick device to type on their computer.
Content to consider in body of letter: 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.
The purpose of this form is to determine whether an employee has a disability that qualifies for an accommodation consistent with the Americans with Disabilities Act (ADA) and must be completed by the treating healthcare provider.
I am experiencing the following difficulties in performing my job because of my disability: . I am writing to request that you (state requested accommodation) because it will (how it will help you do your job) as a reasonable accommodation.
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Your doctor will want you to sign a consent form, allowing the doctor to provide details about your medical condition that would otherwise have to be kept confidential. Once youve given your consent, the doctor should write a brief letter explaining your condition and suggesting possible accommodations.
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.
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.

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