TO: (1) ____________________________
FROM: (2) ____________________________
RE: Request for Reasonable Accommodation
DATE: (3) ________________________
This is a request for reasonable accommodation under the Americans with Disabilities Act (ADA) and the California Fair Employment and Housing Act (FEHA). If you are not the appropriate person to receive this request, please notify me immediately, and forward this letter on to the person who handles requests for reasonable accommodation.
I am a person with a “disability” under the ADA and the FEHA. [My condition is (4) _________________.] Due to my disability, I need (5) _______________________________________________.
According to the ADA and the federal Equal Employment Opportunity Commission (EEOC), communication access is a form of reasonable accommodation. See 42 U.S.C. § 12111(9)(B), EEOC Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act (Oct. 17, 2002), and EEOC Factsheet, Questions and Answers about Deafness and Hearing Impairments in the Workplace and the Americans with Disabilities Act (July 26, 2006), all available at www.eeoc.gov.
Please let me know if you require reasonable medical documentation of my condition, or if you wish to propose alternative accommodations to those I have requested. I am available and eager to engage in the interactive process with you.
(1) Name of Human Resources director, supervisor, program director, or another manager
(2) Your name
(3) Today’s date
(4) Optional: State the name or a description of your condition using language you feel comfortable with.
(5) Explain what form of accommodation you are requesting, such as: “an ASL interpreter during training sessions, performance reviews, and staff meetings.”
Accommodations for workers who are deaf or hard of hearing include:
- in-person or remote sign language or real-time captioning (CART) for communication;
- written minutes or notes summarizing meetings;
- sign language to access English language documents;
- telephone technology such as an amplified headset, a captioned telephone, or a video phone;
- visual doorbells, telephones, and emergency alarms;
- use of a hearing dog;
- another accommodation.