Self-Report

Employees should complete the Employee Accommodation Request Form, which provides employees an opportunity to describe their disability and any accommodations they are requesting. The Accommodation Request Form also includes the ability to attach supporting third-party documentation.

Employees may supplement their Accommodation Request Form with additional information. Employees may consider including additional information about their experiences related to their disability, the challenges or barriers encountered, and/or previous accommodations. Employee accommodations are determined by the Dartmouth ADA Office.

Documentation

Disability-related documentation should provide information about the current impact of the condition in order to determine appropriate accommodations. This information may include assessments, reports, and/or letters from qualified evaluators, professionals, or institutions. Common sources of documentation are health care providers, psychologists, and diagnosticians. Clinicians are generally expected to have an established relationship with the employee and should not be related to the employee. Evidence of accommodations approved from previous institutions/organizations such as accommodation agreements or letters can also be included as additional supporting information.

Suggested Documentation Elements

  1. Typed on letterhead, dated, and signed by a qualified professional including a licensure number.
  2. Provide start date of clinical relationship with client and the most recent interaction. If appropriate, include the frequency of recurring meetings.
  3. Clearly state the condition(s) or disabilities, including date(s) of onset and prognosis.
  4. Describe the impact or symptoms of the condition(s) or disabilities, including impact of major live activities.
  5. Relevant information regarding the severity.
  6. For conditions that are cyclical in nature, describe the frequency, manner, and duration of active symptoms.
  7. If necessary, list relevant treatment or medication side-effects. 
  8. Any recommended accommodations should include a rationale with a clear relationship to the impact of the condition, symptoms, or medication side-effects.