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Office of Institutional Equity

Faculty and Staff Request for Reasonable Workplace Accommodation Form

The purpose of this form is to assist the University in determining whether, or to what extent, a reasonable accommodation is required for an employee with a disability to perform one or more essential functions of their job safely and effectively.  This form must be filed separately from the employee's personnel file and be treated confidentially.

Click here to download the form online. A downloadable version of the form can be found here