Reasonable Adjustment Request form template

£ 15

Our Reasonable Adjustment Request Form Template enables employees to request accommodations, ensuring inclusivity and compliance with disability regulations.

reasonable adjustment request form template

Why this form is necessary

The Reasonable Adjustment Request Form allows employees to formally request accommodations or modifications to their work environment, tasks, or procedures to accommodate their specific needs or disabilities. It provides a structured process for employees to communicate their requirements, enabling employers to consider and implement appropriate adjustments to support their inclusion and participation in the workplace.

This form promotes inclusivity and equal opportunities by facilitating open communication between employees and employers regarding reasonable adjustments.

It helps ensure that employees with disabilities or specific needs receive the necessary support to perform their roles effectively and access the same opportunities for career progression as their colleagues.

  • Equality Act 2010: Mandates employers to make reasonable adjustments for employees with disabilities or health conditions.

  • Data Protection Act 2018 (incorporating GDPR): Dictates the handling of personal data within the reasonable adjustment request form in compliance with data protection principles.

  • Health and Safety at Work Act 1974: Obliges employers to ensure the health, safety, and welfare of employees, which may include making reasonable adjustments.

  • Employment Rights Act 1996: Sets the legal framework for employment contracts and terms, including the provision of reasonable adjustments.

  • Disability Discrimination Act 1995 (DDA): Though repealed, previous versions of the DDA established obligations similar to those in the Equality Act regarding reasonable adjustments for disabled employees.

Workflow sequence

Previous step
Policies
Reasonable Adjustment policy

Our Reasonable Adjustment Policy Template ensures fair treatment and accessibility for employees with disabilities, outlining procedures for identifying, implementing, and reviewing accommodations to support their work performance and wellbeing.

This step
Reasonable Adjustment Request form template
Next step
Forms
Reasonable Adjustment Assessment Checklist form template

Our Reasonable Adjustment Assessment Checklist Form Template helps evaluate and implement accommodations, ensuring fair treatment and accessibility for employees with disabilities.

Specifications

Reading time icon
Time to read / prep / use
5 mins
Document specs icon
Word count / length
102 words, 1 page A4
Date last reviewed icon
Date last reviewed
1 November 2024

Reasonable Adjustment Request

Employee Information:

Name: _________________________

Employee ID: ___________________

Department: ____________________

Job Title: _______________________

Contact Details: ________________

Nature of Disability/Condition:

Please describe the disability/condition for which you are requesting reasonable adjustments:

Requested Adjustments:

Please specify the adjustments you are requesting:




Impact on Work:

How does your disability/condition impact your ability to perform your job duties?

Additional Information:

Is there any additional information you would like to provide to support your request?

Approval:

Employee Signature: _________________________ Date: ____________

Manager/HR Approval:

Approved

Not Approved

Manager/HR

Signature: _________________________ Date: ____________

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Version: [1.0]

Issue date: [date]

Why choose our Reasonable Adjustment Request form template?

Our content:

Is easy to edit and execute, with comprehensive implementation guidance.
Is designed by accredited, experienced HR practitioners.
Maintains your compliance with ACAS guidelines, legislation, and industry best practices.
Includes 12 months access to your purchase, with email alerts if updated or expanded.

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