Request Summary
A concise statement of the limitation and the specific accommodation requested, explaining how the change will reduce the identified barrier to equal access or performance.
A completed written request clarifies the accommodation sought, creates a dated record, and starts the legal interactive process between requester and provider.
Individuals affected by disabilities and the organizations that receive accommodation requests use this document to formalize needs and start the process.
Electronic submission is commonly accepted but should meet basic file, security, and authentication standards to protect privacy and ensure legal validity.
Aim to acknowledge receipt within 3–5 business days for good practice.
Engage promptly; complex cases may require multiple exchanges over days or weeks.
Make and document an initial determination as soon as practical given medical or operational constraints.
Coordinate start dates based on feasibility, medical timelines, and business needs.
Schedule reviews periodically for temporary or evolving accommodations.
A concise statement of the limitation and the specific accommodation requested, explaining how the change will reduce the identified barrier to equal access or performance.
A focused description of how the disability affects essential job functions or housing use, avoiding unnecessary medical detail while clarifying practical needs.
One or more suggested reasonable adjustments, plus any alternatives and the requester’s flexibility for alternatives proposed during the interactive process.
A checkbox and attachment area for provider documentation or permission to contact the provider, respecting confidentiality and HIPAA when applicable.
Fields for administrative use to record dates, points of contact, decisions, and implementation steps to ensure an auditable process.
A brief explanation of how to request reconsideration or escalate if the initial decision is disputed.
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