ADA Questionnaire form - PHPA - Maryland 2025

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This is not an exhaustive list under the ADA, appropriate professionals may also include certified physician assistants, nurse practitioners, social workers, and other professionals.
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.
Write down precisely what job-related limitations your condition imposes and note how they can be overcome by accommodations. Identify potential accommodations and assess how effective each would be in allowing you to perform the job. Document all aspects of the accommodation--including cost and availability.
The ADA is a civil rights law that prohibits discrimination against individuals with disabilities in all areas of public life, including jobs, schools, transportation, and all public and private places that are open to the general public.
At the start, proving disability discrimination first requires the employee to prove they meet the technical legal definition of a disability. In most cases, that entails the employee showing he or she has a physical or mental impairment that substantially limits one or more major life activities of such individual.