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Rutgers University Accommodation Request: Medical Inquiry Form 2018-2025 free printable template

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Office of Employment Equity ACCOMMODATION REQUEST: MEDICAL INQUIRY From This form is to be used by a Rutgers University staff member to request medical information from his/her healthcare provider.
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How to fill out Rutgers University Accommodation Request: Medical Inquiry Form

01
Obtain the Rutgers University Accommodation Request: Medical Inquiry Form from the university's website or office.
02
Read the instructions carefully before filling out the form.
03
Provide your personal information in the designated sections, including your name, student ID, and contact details.
04
Describe your medical condition or disability in detail, including any relevant diagnoses.
05
Indicate the specific accommodations you are requesting to support your academic success.
06
Obtain documentation from a qualified healthcare professional that supports your request for accommodations.
07
Attach the medical documentation to the form where indicated.
08
Review the completed form for accuracy and completeness.
09
Submit the form and accompanying documents to the appropriate office at Rutgers University by the specified deadline.

Who needs Rutgers University Accommodation Request: Medical Inquiry Form?

01
Students at Rutgers University who have a medical condition or disability that may require accommodations for their studies.
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Only admitted students who are offered a scholarship are notified of their awards. Incoming first-year admitted students are notified beginning in early March. Spring transfer admitted students are notified of their awards in December, while fall transfer admitted students are notified in March.
A Reputation for Learning Excellence Rutgers perennially appears in the most respected annual listings of the world's top universities. And we are the only university in the United States that is a colonial college, a land-grant institution, and a leading national public research university.
Legacy UMDNJ: For the purposes of identifying positions within payroll and benefits administration, Rutgers uses the term legacy UMDNJ position to denote a position which, historically, was associated with the former University of Medicine and Dentistry of New Jersey (UMDNJ).
The University prohibits retaliation against individuals requesting reasonable accommodations or academic adjustments; appealing or filing complaints related to decisions concerning such requests; or making or participating in claims of discrimination or harassment.
Legacy Rutgers: See Rutgers Position. Legacy UMDNJ: For the purposes of identifying positions within payroll and benefits administration, Rutgers uses the term legacy UMDNJ position to denote a position which, historically, was associated with the former University of Medicine and Dentistry of New Jersey (UMDNJ).
Exempt (NL) employees are not eligible to receive overtime pay or compensatory time. Non-exempt (NE) employees are eligible to receive overtime pay and, under certain conditions, compensatory time in lieu of overtime pay. Within the university, non- exempt employees have a workweek designation of NE (37½), 35, or 40.

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The Rutgers University Accommodation Request: Medical Inquiry Form is a document used by students seeking accommodations for medical reasons at the university. It allows students to formally request necessary adjustments based on their health-related needs.
Students who require academic accommodations due to a medical condition or disability are required to file the Rutgers University Accommodation Request: Medical Inquiry Form.
To fill out the form, students need to provide their personal information, details of their medical condition, specify the accommodations they are requesting, and may need to include supporting documentation from a healthcare provider to validate their needs.
The purpose of the form is to facilitate the process for students to obtain the necessary accommodations that will support their academic success while taking into account their medical conditions or disabilities.
Students must report their contact information, a description of their medical condition, specifics on the accommodations requested, and any relevant medical documentation from a licensed professional that supports their request.
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