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Hud reasonable accommodation request form 2025

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The document is a Reasonable Accommodation Request Form from the Department of Mental Health and Addiction Services, designed for employees and applicants to request accommodations under the Americans with Disabilities Act (ADA). It outlines the necessary information to be provided, including details about the individual's disability, its impact on major life activities, and the specific accommodation requested. The form also includes sections for facility EEO specialists and HR directors to assess and respond to the requests.

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Click ‘Get Form’ to open the hud reasonable accommodation request form in the editor.
Begin by selecting either Box 1 for DMHAS employees or Box 2 for applicants. Fill in the required fields such as Date, Name, Position Title, and Work Location for employees, or Position Applied For for applicants.
Provide a detailed description of your physical or mental impairment and how it limits major life activities. Be specific about how it affects your job functions if you are an employee.
Clearly describe the accommodation you are requesting and explain how it will assist you in performing your job effectively.
Complete your contact information, including mailing address and phone number, ensuring that all details are accurate.
Review all sections for completeness before submitting the form to the facility EEO specialist.

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Versions	Form popularity	Fillable & printable
2015	4.6 Satisfied (35 Votes)
2010	4.8 Satisfied (23 Votes)

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How do you write a reasonable accommodation request?

Reasonable accommodation can include, but is not limited to, the following: Changing job duties. Providing leave for medical care. Changing work schedules. Relocating the work area. Providing mechanical or electrical aids.

What is an example of a reasonable accommodation for persons with disabilities?

Reasonable accommodation includes offering flexible working hours or modified work schedules to allow employees with disabilities to work without sacrificing their health or wellbeing. This might include: Changes in start/finish times to allow for greater time taken for commuting to/from place of work.

What do you write in a reasonable accommodation request?

I am writing to request accommodations in the workplace. I have worked at [insert company name] as a [insert your job position] since [approximate date you were hired]. I am experiencing some difficulties in effectively performing my job because of my disability.

What qualifies as a reasonable accommodation?

Under Title I of the Americans with Disabilities Act (ADA), a reasonable accommodation is a modification or adjustment to a job, the work environment, or the way things are usually done during the hiring process.

How to make a reasonable accommodation request?

Prepare by writing down exactly what you need and determining what details you are going to share about your specific condition, illness, or disability. (Remember: you dont owe anyone an explanation for why you need the accommodation.) If you arent sure what you need, check out askjan.org to get ideas.

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What is an example of reasonable accommodation?

Sufficient medical documentation should describe the nature, severity, and duration of the impairment, the activity or activities that the impairment limits, the extent to which the impairment limits the employees ability to perform the activity or activities, and should also substantiate why the requested reasonable

Hud reasonable accommodation request form 2025

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