HIPAA Authorization for Request for Accommodation

This template is an HIPAA Authorization that allows an employer to communicate directly with the employee's medical provider in relation to an employee's accommodation request. It contains practical guidance and drafting notes. This template 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. All medical questions to the doctor by the employer must be limited to the particular condition that the request is sought for. For a full listing of key content covering HIPAA considerations, see HIPAA Resource Kit. For information on HIPAA compliance in the workplace, see Confidential Medical Information in the Employee Leaves and Disability Context (Including Dobbs Considerations). Also see HIPAA Privacy, Security, Breach Notification, and Other Administrative Simplification Rules.