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Letter template

Reasonable Accommodation Request Letter

A template for putting a request for a change at work in writing, with four condition-specific versions, an official source for every legal point, and the EEOC filing windows. General information, not legal advice.

By Editorial Team Published July 12, 2026 Last reviewed August 27, 2026 Next review February 2027

The short version

Before you send, fill in

  • Your name
  • Your role or team
  • Manager or HR contact name
  • Date
  • A brief description of the barrier
  • The specific change you are requesting

The letter

Dear [Manager or HR contact name],

I am writing to request an adjustment at work related to a health condition. I want to keep doing my job well, and I believe a small change would help me do that.

Specifically, I would like to request: [the specific change you are requesting]. This would help with [a brief description of the barrier].

I am happy to discuss options, and I am open to alternatives that would work just as well. If it would help, I can provide supporting information from my healthcare provider.

Thank you for considering this request. I would appreciate the chance to talk it through at your convenience.

Sincerely,

[Your name], [Your role or team]

Text in [brackets] is a placeholder to replace.

Four condition-specific versions

In the letter above, the paragraph beginning "Specifically" is the one that changes from person to person: it names the limitation and the change being requested. Below are four versions of it, each written from the limitations described on the matching condition guide. They are sample language to adapt, not wording the law calls for, and the condition labels only organize the examples.

  1. Version 1

    ADHD

    Keyed to the limitations set out on the ADHD guide: staying focused in open, noisy, or high-interruption spaces; managing time, deadlines, and switching between tasks; and holding spoken, multi-step instructions in memory. See ADHD accommodations at work.

    Specifically, I would like to request noise-reducing headphones, a desk away from the main walkway, and a short written summary to follow up assignments that are given to me in conversation. In our open office I lose focus and miss details, and multi-step instructions given out loud are hard for me to hold on to. I believe these changes would help me hit deadlines more reliably. I am open to alternatives that would work just as well.
  2. Version 2

    Anxiety

    Keyed to the limitations set out on the anxiety guide: concentrating when anxiety or worry is high; staying regulated under pressure or tight deadlines; and panic symptoms that can surge during meetings, presentations, or busy periods. See Anxiety accommodations at work.

    Specifically, I would like to request a quieter workspace, the option to take a short break when I need to reset, and key instructions in writing. Anxiety makes it hard for me to concentrate, and busy meetings can bring on panic symptoms. I believe these changes would help me stay focused and steady through the day. I am open to alternatives that would work just as well.
  3. Version 3

    Chronic illness or fatigue

    Keyed to the limitations set out on the chronic illness guide: fatigue and reduced stamina across a full workday; symptoms that flare up and are hard to predict from day to day; and keeping regular attendance and set hours during flares and treatment. See Chronic illness accommodations at work.

    Specifically, I would like to request a flexible start and end time, the option to work from home when I am flaring, and a few additional short rest breaks on harder days. My condition brings good days and harder days, my stamina drops across a full shift, and some weeks I have treatment appointments. I believe these changes would help me keep my work on track. I am open to alternatives that would work just as well.
  4. Version 4

    Pregnancy, under the PWFA

    Keyed to the limitations set out on the pregnancy guide: standing or sitting in one position for long stretches; nausea, and needing to eat, drink water, or use the restroom more often; and lifting, carrying, pushing, or pulling. See Pregnancy accommodations at work.

    Specifically, I would like to request a stool at my station, two additional short breaks to eat, drink water, and use the restroom, and help with the heavier lifting on my shift. Standing for a full shift has become hard because of a limitation related to my pregnancy. I believe these changes would let me keep up with the work. I am open to alternatives that would work just as well.

What the law says about asking

There is no federal accommodation request form and no required phrasing. The EEOC's Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the ADA (opens in a new tab) answers this at Question 1: a person "may use 'plain English' and need not mention the ADA or use the phrase 'reasonable accommodation'", and "Requests for reasonable accommodation do not need to be in writing." A letter is therefore one way of asking, not a step the law requires.

What is being asked for is defined in the regulation. Under 29 C.F.R. 1630.2(o)(1) (opens in a new tab), a reasonable accommodation includes "modifications or adjustments to the work environment, or to the manner or circumstances under which the position held or desired is customarily performed", where those changes enable a qualified individual with a disability to perform the essential functions of the position.

A request is the opening of a conversation rather than a form to be approved or refused. 29 C.F.R. 1630.2(o)(3) (opens in a new tab) states in full: "To determine the appropriate reasonable accommodation it may be necessary for the covered entity to initiate an informal, interactive process with the individual with a disability in need of the accommodation. This process should identify the precise limitations resulting from the disability and potential reasonable accommodations that could overcome those limitations." That regulation is what stands behind the closing sentence of each version above, which offers to discuss alternatives.

A step-by-step walkthrough of that process is on the interactive process.

What an employer may ask for

Where a disability or the need for an accommodation is not obvious, the EEOC enforcement guidance, at Question 6 (opens in a new tab), states that an employer may ask for reasonable documentation about the condition and the limitation. The same answer sets the boundary: an employer "cannot ask for documentation that is unrelated to determining the existence of a disability and the necessity for an accommodation", and "in most situations an employer cannot request a person's complete medical records because they are likely to contain information unrelated to the disability at issue".

A separate limit covers medical examinations and inquiries of current employees. 29 C.F.R. 1630.14(c) (opens in a new tab) permits a covered entity to require one only where it is "job-related and consistent with business necessity".

Under the PWFA the limit is tighter for four common pregnancy-related requests that the EEOC calls predictable assessments (opens in a new tab): carrying water and drinking as needed, additional restroom breaks, sitting when the job requires standing or standing when the job requires sitting, and breaks to eat and drink. For these, the agency states an employer should not seek supporting documentation.

The deadlines the law sets

A request letter is not a charge of discrimination, and a charge is not part of the interactive process. It is the charge that carries a filing deadline.

On its Time Limits for Filing a Charge (opens in a new tab) page, the EEOC states: "In general, you need to file a charge within 180 calendar days from the day the discrimination took place." It also states that "The 180 calendar day filing deadline is extended to 300 calendar days if a state or local agency enforces a law that prohibits employment discrimination on the same basis."

What these numbers are and are not.This page states the windows the EEOC publishes. It does not work out which window applies to a particular situation or when a clock would have started, because that turns on facts and on state law a general information page cannot know. The EEOC page linked above is the official statement of the rule, and further background is at deadlines that matter.

A template, not legal advice.This is a general information page published by an independent, privately run resource. It is not a government agency, a law firm, or a medical provider, and nothing here is tailored to any individual situation or creates an attorney-client relationship. The wording above is a starting point to adapt, and it will not fit every case. Where a situation is complicated or a deadline may be close, an employment lawyer or a local disability rights organization can advise on the specific facts.

Sources

The official and primary sources behind every legal statement on this page. Each one is also linked inline at the point it is used.

  1. Enforcement Guidance on Reasonable Accommodation and Undue Hardship Under the ADA (opens in a new tab) U.S. Equal Employment Opportunity Commission Question 1 covers how a request is made. Question 6 covers what documentation an employer may ask for.
  2. 29 C.F.R. 1630.2, Definitions (including (o)(1), reasonable accommodation, and (o)(3), the interactive process) (opens in a new tab) Electronic Code of Federal Regulations, EEOC regulations implementing the ADA
  3. 29 C.F.R. 1630.14, Medical examinations and inquiries specifically permitted (opens in a new tab) Electronic Code of Federal Regulations, EEOC regulations implementing the ADA
  4. Time Limits for Filing a Charge (opens in a new tab) U.S. Equal Employment Opportunity Commission
  5. What You Should Know About the Pregnant Workers Fairness Act (opens in a new tab) U.S. Equal Employment Opportunity Commission

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