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County of Ingham HUMAN RESOURCES DEPARTMENT Employee Accommodation Request Form (ADA) EMPLOYEE NAME EMPLOYEE NUMBER JOB TITLE DEPARTMENT EMPLOYEE SIGNATURE DATE A. Questions to clarify accommodation

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What is employee accommodation request form?

Employee accommodation request form is a document that employees can use to request accommodations due to medical reasons or disabilities.

Who is required to file employee accommodation request form?

Employees who require accommodations due to medical reasons or disabilities are required to file the employee accommodation request form.

How to fill out employee accommodation request form?

Employees can fill out the employee accommodation request form by providing their personal information, medical documentation, and details of the accommodation requested.

What is the purpose of employee accommodation request form?

The purpose of the employee accommodation request form is to ensure that employees with medical needs or disabilities are provided with necessary accommodations to perform their job duties.

What information must be reported on employee accommodation request form?

The employee accommodation request form should include the employee's personal information, details of their medical condition or disability, and specific accommodations requested.

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