The accommodation form your employer wants, completed correctly

A workplace accommodation form is the medical paperwork your employer or school uses to document a health condition or disability and the adjustment you're asking for. Under the ADA (Americans with Disabilities Act), when your disability or your need for the accommodation isn't obvious, an employer or school can ask for documentation that supports the request. That documentation usually takes the form of an accommodation letter or a Physician Statement. When the accommodation you need is time off, it may instead be "Leave as an Accommodation" paperwork.

The form doesn't hand over your full medical records. It documents what your employer or school needs to act on the request — the functional limits relevant to your accommodation and the adjustment that addresses them.

Plenty of offices won't. Some don't complete employer or school forms at all; others charge per form, book weeks out, or only serve patients they've seen recently. None of that means your request is stuck.

Certicare completes the form instead. A state-licensed provider reviews your answers, then completes and signs the accommodation paperwork your employer or school requested. There's no prior relationship required and no appointment to book. A licensed provider still reviews your request on its merits, and won't sign documentation that isn't clinically supported.

Usually one of three documents: a workplace accommodation letter or form, a Physician Statement, or "Leave as an Accommodation" paperwork when the accommodation is time off. You don't have to know which. Your employer or school tells you which one, and Certicare completes that exact form to its requirements.

What it doesn't include is your full medical chart. The form documents the limits relevant to your request and the accommodation that addresses them, so your employer sees what they need to decide — not your history.

Yes. No video visit, no appointment. You answer a short online questionnaire about your condition and the accommodation you're requesting. A state-licensed provider reviews those answers, then completes and signs the form.

The completed form arrives by email. If your employer or school follows up with an RFI (request for additional information), that gets handled at no additional charge.

Secure online intake. Your information is reviewed by Certicare and is not sent to your employer or school without your authorization.

The completed form usually arrives within 24 hours after we have everything needed — your questionnaire answers and the form your employer or school sent you. Email replies usually come the same day; anything after 6 pm ET is usually answered the next morning.

The fee is $49 flat, shown before you start. If the form can't be completed, you get a full refund, and you can request a refund any time before your form is delivered.

Rebecca Martel, APRN, FNP-BC, is a family nurse practitioner who has completed hundreds of these forms. As a neurodivergent person who lost jobs to cyclical burnout early in her career, she knows what's at stake when paperwork stalls.