ADA Accommodation Request Template — Employee Notice & Interactive Process
Template to request a reasonable accommodation at work under the ADA. Includes functional limitation description, requested accommodation, medical documentation, interactive-process steps, confidentiality, and response timelines.
Related topics: employment, ADA, accommodation, disability, hr, workplace, request, interactive process
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ADA ACCOMMODATION REQUEST — FORMAL NOTICE Date: [date] To: [hr_department] From: [employee_name] Position: [position_title], Department: [department] Supervisor: [supervisor_name] Re: Request for reasonable accommodation under the Americans with Disabilities Act (ADA) 1. INTRODUCTION I am requesting a reasonable accommodation for a disability or functional limitation that affects my ability to perform one or more essential functions of my position. I am providing this written notice to begin the...