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Print this PageSample Accommodation Related Forms
- Sample Reasonable Accommodation Request Form for Employers (.doc) - JAN Sample Form
- Corresponding Publication: Accommodation and Compliance Series: Sample Reasonable Accommodation Form for Employers - JAN Publication
- Accommodation and Compliance Series: Medical Inquiry in Response to an Accommodation Request - JAN Publication (.doc) - JAN Sample Form
- Corresponding Publication: Accommodation and Compliance Series: Medical Inquiry in Response to an Accommodation Request - JAN Publication
- Practical Guidance for Medical Professionals: Providing Sufficient Medical Documentation in Support of a Patient's Accommodation Request - JAN Publication and Sample Letter (.doc)
- Sample Accommodation Approval Form (.doc) - JAN Sample Form
- Sample Accommodation Denial Form (.doc) - JAN Sample Form
- Kaiser Permanente Return to Work Functional Assessment Form (.doc) - For use by physicians to return employees back to work at full duty or provide work restrictions/capacities for employees returning via a transitional work program - and Physical Capacities Assessment Form (.doc)
