Disability Accommodation Request


This form is a disability accommodation request that an employee can use to request a reasonable accommodation under the Americans with Disabilities Act (ADA). This template includes practical guidance and drafting notes. This form is intended for private employers. It is based on federal law and does not address all potential state law distinctions; thus, you should check any relevant state and local laws. For information on ADA and disability management, see Attendance, Leaves, and Disability—The ADA and Disability Management. For more information on what is a reasonable accommodation under the ADA, see Employment Law Answer Book (CCH) Q 4:128. For information on requests for accommodations, see ADA: Employee Rights § 6.03[2][c]. For an annotated Resolution of Employee's Request for Accommodation, see Disability Accommodation Request Resolution (ADA). For information on state laws concerning disability accommodation, see the relevant state law practice notes in Discrimination, ...