June 1, 2026 [recipient name] [recipient address] Re: Request for Reasonable Accommodation — Americans with Disabilities Act Dear [recipient name]: Pursuant to Title I/III of the Americans with Disabilities Act, 42 U.S.C. § 12101 et seq., I am formally requesting the following reasonable accommodation: [accommodation] Facts / supporting context: [facts] Requested resolution: [desired outcome] I request that we engage in the interactive process required by the ADA. Please respond in writing within fourteen (14) days with either an agreement to provide this accommodation, a proposed alternative, or a written explanation of any claimed undue hardship. Sincerely, [user full name] [user address]
ADA Title II · State or Local Government Services
Need to request a leave as an accommodation adjustment for a health condition?
Generate a formal Accommodation Notice to initiate the official interactive process.
You do not have to struggle in an environment that doesn't accommodate your documented medical needs. Federal compliance frameworks protect your right to reasonable adjustments. Use our informational utility to generate a professional Accommodation Request — such as intermittent leave, extended unpaid leave beyond FMLA, or a finite block of time away from work for treatment or recovery — that clearly outlines your requirements to the responsible decision-maker.
Your rights: the ADA Title II framework
Governing statute
Title II of the Americans with Disabilities Act (42 U.S.C. § 12132)
State and local government agencies must provide reasonable modifications to policies, practices, and procedures to avoid discrimination on the basis of disability.
Mandatory interactive process
Title II covers all programs and activities of state and local governments — a formal request triggers the agency's ADA Coordinator obligations.
Protected status
Formally documenting your request establishes an official timeline, protecting your standing and preventing your request from being filed away or ignored.
What you're requesting
A leave as an accommodation accommodation, such as intermittent leave, extended unpaid leave beyond FMLA, or a finite block of time away from work for treatment or recovery.
Documentation to gather
Gather a provider letter estimating the duration of needed leave, document any prior approved leave periods, and identify your expected return-to-work timeline.
Choose a different dispute
Government
ADA Accommodation Request
Question 1 of 714%
The person, company, or agency this letter is addressed to.
✓ Triggers the ADA interactive-process requirement
- 256-bit Encryption
- Bank-Level Privacy
- No Monthly Subscription
Live preview — updates as you type
Unlock full draft — $14.99
Other accommodations for state or local government services
- Remote Work / Telework Flexibility — State or Local Government Services
- Modified or Reduced Schedule — State or Local Government Services
- Assistive Technology — State or Local Government Services
- Workstation Modification — State or Local Government Services