ADA Disability Accommodation Form

The University of Oregon recognizes that disability is a critical component of diversity in the workplace. More information about the process can be found in our Workplace Accommodation eLearning module.


The Accommodations Coordinator is responsible for administering the interactive process for university employees to request workplace accommodations. Each request is assessed on an individual basis.


As an initial step in the accommodation process, please answer the questions on this request form. This information will help the Accommodations Coordinator understand how your disability or medical condition impacts you in the workplace and what accommodations you believe would help address your needs.


Next, the employee requesting an accommodation will be asked to have their healthcare provider complete the university’s Medical Provider Form and submit it to the Accommodations Coordinator. The Medical Provider Form is narrowly tailored to help ensure receipt of limited information necessary to assess an employee’s eligibility for workplace accommodations.


To designate a support person, you must complete a Support Person Authorization form and upload to this form.


Please contact workplaceADA@uoregon.edu with questions.