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Below is a template for an ADA (Americans with Disabilities Act) form that a doctor or healthcare provider might use in a workplace setting. This template provides a structure that can be adapted to specific needs and situations.
Date: _____________________________________________________________. A sample form for an employee to request an accommodation due to disability.
A sample form for a health care provider to complete when an employee requests an ADA accommodation.
JAN offers tools that may be useful to employers in the process of requesting medical documentation. See JAN's Medical Inquiry in Response to an Accommodation Request and JAN's Practical Guidance for Medical Professionals: Providing Sufficient Medical Documentation in Support of a Patient's Accommodation Request.
According to the Equal Employment Opportunity Commission (EEOC) and Title I of the Americans with Disabilities Act (ADA), each request for a reasonable accommodation must be considered on a case-by-case basis. This page reviews the various phases of the reasonable accommodation process.
Title III of the Americans with Disabilities Act (ADA) declares medical offices and hospitals as “public accommodations” that must comply with ADA regulations. It is important for people with disabilities to receive medical services equal to those services received by a person without a disability.
14 paź 2021 · This handout includes sample documentation healthcare professionals can customize for patients who are seeking workplace accommodations.
