CONFIDENTIAL Reasonable Accommodation Request Form 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your affiliation and department/unit. This helps identify your role within Harvard University.
3. Enter your personal details, including your name, work telephone, job title, preferred telephone, work address, and preferred email. Accurate information ensures effective communication.
4. Specify the accommodation you are requesting in the designated field. Be as detailed as possible to assist in evaluating your needs.
5. Sign and date the form to authorize Harvard University to explore accommodations under the ADA. Ensure you understand the confidentiality of this process.
6. Complete the authorization section by providing details of your health care provider(s) who will assist in evaluating your request.
7. Review all entries for accuracy before submitting the completed form to University Disability Services.

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