Get the free Reasonable Accommodation Request Form - purdue

This form is used by Purdue University employees to request reasonable accommodations under the Americans with Disabilities Act (ADA) for physical and/or mental impairments affecting their job performance.

How to fill out reasonable accommodation request form

How to fill out Reasonable Accommodation Request Form

1. Obtain the Reasonable Accommodation Request Form from your HR department or website.
2. Fill out your personal information, including name, address, and contact details.
3. Provide details about your disability or condition that requires accommodation.
4. Specify the type of accommodation you are requesting.
5. Include any relevant medical documentation if required.
6. Sign and date the form once completed.
7. Submit the form to your HR department, either in person or via email.

Who needs Reasonable Accommodation Request Form?

1. Employees with disabilities who require adjustments to their work environment.
2. Individuals seeking modifications to their job duties or work schedule due to a medical condition.
3. Any person who is experiencing barriers to performing their job effectively due to a disability.

People Also Ask about

What is an example of a reasonable accommodation statement?

Abbreviated Reasonable Accommodation Statement To be used when space is limited: Anyone with a disability who would like to request accommodations or who has questions about physical access may contact [insert email and telephone number of the program/event sponsor] in advance of the program or visit.

What to say in a reasonable accommodation request?

(Name of public entity) does not discriminate on the basis of disability in its services, programs, or activities. Employment: (Name of public entity) does not discriminate on the basis of disability in its hiring or employment practices and complies with the ADA title I employment regulations.

What is an example of an accommodation statement?

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.

How do you write a good reasonable accommodation request?

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.

Is there an ADA accommodation form?

ing to the Equal Employment Opportunity Commission (EEOC), the federal agency charged with enforcing the ADA, an accommodation request does not have to be in writing and the ADA does not include specific guidelines or forms for requesting reasonable accommodation.

What documentation is needed for a 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 employee's ability to perform the activity or activities, and should also substantiate why the requested reasonable

What are examples of reasonable accommodations?

Sample Statements If you need disability-related accommodations, please call [insert telephone number of the sponsor]. Persons with disabilities who anticipate needing accommodations or who have questions about physical access may call [telephone number of the sponsor] in advance of the program [or film, event, etc.].

For pdfFiller’s FAQs

What is Reasonable Accommodation Request Form?

The Reasonable Accommodation Request Form is a document used by employees or applicants to formally request modifications or adjustments to their work environment or job functions due to a disability.

Who is required to file Reasonable Accommodation Request Form?

Employees or applicants who require modifications to their workplace or job duties due to a disability are required to file the Reasonable Accommodation Request Form.

How to fill out Reasonable Accommodation Request Form?

To fill out the Reasonable Accommodation Request Form, individuals should provide their personal information, describe their specific disability, detail the accommodation they are requesting, and explain how it will assist them in performing their job.

What is the purpose of Reasonable Accommodation Request Form?

The purpose of the Reasonable Accommodation Request Form is to facilitate the request for necessary adjustments that allow individuals with disabilities to work effectively and equitably.

What information must be reported on Reasonable Accommodation Request Form?

The Information required includes the employee's name, contact information, a description of the disability, the specific accommodations requested, and any supporting medical documentation if necessary.