TEMPLATE: HOW TO REQUEST A REASONABLE ACCOMMODATION
Date
Your Name
Your Address
Mr. / Mrs. / Ms. / Mx. __________ [Insert human resource or managers name]
Company Name
Company Address
Dear Mr. / Mrs. /Ms. / Mx. __________ [Insert human resource or managers name],
I am writing to request accommodations in the workplace. I have worked at __________ [insert company name] as a ______________ [insert your job position] since ___________ [approximate date you were hired]. I am experiencing some difficulties in effectively performing my job because of my disability. For example, _____________________________ [insert difficulties your facing].
I am requesting that you____________________ [insert requested accommodation]. I believe that this accommodation will ____________ [describe how accommodation(s) will help you do your job].
I would like to meet with you to discuss my request so that we can work together to find an effective accommodation.
If you would like to learn more about my rights under the Americans with Disabilities Act, you can contact the Job Accommodation Network (JAN) at 1-800-526-7234 or review their website (https://askjan.org/info-by-role.cfm#for-employers).
Please let me know what, if any, additional information you need from me and if you have any questions about my request. I would appreciate a written response to my request within two weeks of the date of this letter. I look forward to your response and appreciate your attention to this matter.
Sincerely,
Your name
Your full address
Your phone number
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