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Model Form: Reasonable Accommodation Request Verification REASONABLE ACCOMMODATION REQUEST VERIFICATION DATE TO HEALTH CARE PROVIDER S NAME HEALTH CARE PROVIDER S ADDRESS FROM COMMUNITY ASSOCIATION
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How to Fill Out Model Form Reasonable Accommodation:

01
Begin by reviewing the instructions on the form to ensure you understand the requirements and purpose of the form.
02
Provide your personal information, including your name, contact information, and any relevant identification numbers.
03
Include details about your current employment or housing situation, such as the name of your employer or the property owner, your position, and address.
04
Clearly state the nature of your request for reasonable accommodation, specifying any disabilities or medical conditions that require accommodation.
05
Describe the specific accommodation you are requesting, providing detailed explanations and any supporting documentation or recommendations from medical professionals, if applicable.
06
Indicate the date you submitted your request and any other relevant dates, such as when you require the accommodation to begin.
07
Sign and date the form, certifying that the information provided is true and accurate to the best of your knowledge.
08
Submit the completed form according to the instructions provided, which may involve sending it to a specific department or individual within your organization or housing provider.

Who Needs Model Form Reasonable Accommodation:

01
Employees or job applicants who have disabilities and require accommodations in the workplace to perform their essential job duties.
02
Individuals seeking accommodations for disabilities in the context of housing, such as tenants or prospective residents.
03
Any person who believes they may need a reasonable accommodation due to a disability, whether it be for employment or housing purposes.
Remember, it is essential to consult the specific guidelines provided by your employer or housing provider when filling out the model form reasonable accommodation, as requirements may vary.
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Model form reasonable accommodation is a document that individuals with disabilities can use to request modifications or adjustments in the workplace or educational setting to accommodate their needs.
Individuals with disabilities who require accommodations in the workplace or educational setting are required to file model form reasonable accommodation.
To fill out model form reasonable accommodation, individuals should provide details about their disability, the type of accommodations needed, and how the accommodations will help them perform their job or receive education.
The purpose of model form reasonable accommodation is to ensure that individuals with disabilities have equal access to opportunities in the workplace or educational setting.
Model form reasonable accommodation should include information about the disability, requested accommodations, and how the accommodations will enable the individual to perform their job or receive education.
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