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ADA Reasonable Accommodation Request

Federal & State Law Editorial TeamLast reviewed: April 2026

Written request for reasonable accommodation under the Americans with Disabilities Act from an employer, business, or public entity.

PDF TemplateUse the instructions below to complete this form

Instructions

You do not need to use specific legal language or mention the ADA. Describe your disability and how it limits your ability to perform job functions or access services. Propose specific accommodations that would enable you to perform essential functions. Include supporting medical documentation if requested by the employer. The employer must engage in an interactive process to identify effective accommodations. Employers may deny requests that impose an undue hardship.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.