CT Reasonable Accommodation Request Form 2015-2025 free printable template

DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES REASONABLE ACCOMMODATION REQUEST FORM REQUEST FOR REASONABLE ACCOMMODATION UNDER THE AMERICANS WITH DISABILITIES ACT Please complete either Box 1

How to fill out

How to fill out CT Reasonable Accommodation Request Form

1. Obtain the CT Reasonable Accommodation Request Form from the official website or your local HR department.
2. Fill out your personal information in the designated fields, including your name, address, and contact information.
3. Clearly state your request for reasonable accommodation in the appropriate section of the form.
4. Provide specific details about your disability and how it affects your ability to perform your job duties.
5. Include any relevant medical documentation or support that verifies your need for accommodation.
6. Specify the type of accommodation you are requesting and any alternative options you may consider.
7. Review the form for completeness and accuracy before submitting.
8. Sign and date the form where indicated.
9. Submit the completed form to your HR department or the designated official, either in person or via email.

Who needs CT Reasonable Accommodation Request Form?

1. Employees with disabilities seeking adjustments or modifications to their workplace or work duties.
2. Individuals needing support due to medical conditions that impact their job performance.
3. Job applicants who require accommodations during the application or interview process.

People Also Ask about

How do you write a good reasonable accommodation request?

I work at __(Company Name) as a __(Your Job Title) and have been in this position since _ (Date). I am writing to request that you provide (list accommodation needed here) as a reasonable accommodation under the ADA.

How do you write a reasonable accommodation letter?

Dear Mr./Ms. (Contact at Human Resources Department): I work at __(Company Name) as a __(Your Job Title) and have been in this position since _ (Date). I am writing to request that you provide (list accommodation needed here) as a reasonable accommodation under the ADA.

What is an example of an accommodation statement?

“We value inclusion and access for all participants and are pleased to provide reasonable accommodations for this event. Please contact [insert contact name and email/phone number] to make a reasonable accommodation request. Requests must be submitted by [insert date].” “This event is wheelchair accessible.

What are examples of reasonable accommodations?

What types of accommodations are generally considered reasonable? Change job tasks. Provide reserved parking. Improve accessibility in a work area. Change the presentation of tests and training materials. Provide or adjust a product, equipment, or software. Allow a flexible work schedule.

Which of the following reasons are legitimate reasons to deny a request for a reasonable accommodation?

The agency may reject an employee's request for a reasonable accommodation for the following reasons: The employee is not an individual with a qualifying disability. The employee is unable to provide requested documentation from a medical professional that demonstrates that he/she has a qualifying disability.

What is an example of a reasonable accommodation request?

Providing an assistant as needed may be a reasonable accommodation for a person with a disability, if this does not impose an undue hardship. Examples include: An assistant may be needed to retrieve items on shelves, file, or selectively assist a person with quadriplegia with other clerical duties.

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What is CT Reasonable Accommodation Request Form?

The CT Reasonable Accommodation Request Form is a document used to request modifications or adjustments in a program, service, or job to accommodate individuals with disabilities.

Who is required to file CT Reasonable Accommodation Request Form?

Individuals who require accommodations due to a disability, including employees and program participants, are required to file the CT Reasonable Accommodation Request Form.

How to fill out CT Reasonable Accommodation Request Form?

To fill out the CT Reasonable Accommodation Request Form, provide your contact information, describe your disability, specify the requested accommodations, and explain how they will assist you in performing essential functions or accessing services.

What is the purpose of CT Reasonable Accommodation Request Form?

The purpose of the CT Reasonable Accommodation Request Form is to formally request accommodations that enable individuals with disabilities to participate fully in programs, services, or employment opportunities.

What information must be reported on CT Reasonable Accommodation Request Form?

The information that must be reported on the CT Reasonable Accommodation Request Form includes personal identification details, a description of the disability, the specific accommodations needed, and the rationale for these requests.