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Office of the State Americans with Disabilities Act Coordinator (OS ADAC)Rev. 6/2022VOLUNTARY SELFIDENTIFICATION OF DISABILITY FORM Employee Name:Personnel #: Why are you being asked to complete this

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How to fill out voluntary self-identification of disability

01

Access the form for voluntary self-identification of disability

02

Provide personal information such as name, employee ID, and contact information

03

Indicate whether you have a disability or not

04

If you have a disability, specify the type of disability you have

05

Submit the completed form to the appropriate HR department

Who needs voluntary self-identification of disability?

01

Employees who want to disclose their disability status for accommodation purposes

02

Employers who are required to collect this information for reporting and compliance purposes

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What is voluntary self-identification of disability?

It is a process where individuals voluntarily disclose whether they have a disability for the purpose of promoting diversity and inclusion in the workplace.

Who is required to file voluntary self-identification of disability?

Employees are not required to disclose their disability, but federal contractors and subcontractors are required by law to invite employees to voluntarily self-identify as having a disability.

How to fill out voluntary self-identification of disability?

Employees can fill out the voluntary self-identification form provided by their employer, usually during onboarding or when requested. The form will typically ask if the individual has a disability and if they are interested in receiving accommodations.

What is the purpose of voluntary self-identification of disability?

The purpose is to collect data on the number of individuals with disabilities in the workforce in order to measure the effectiveness of policies and programs aimed at promoting equal opportunity and inclusion.

What information must be reported on voluntary self-identification of disability?

The information typically includes whether the individual has a disability and if they require any accommodations to perform their job.

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