Workplace accommodation paperwork online

A state-licensed provider reviews your request and, if the medical information supports it, completes and signs the accommodation forms your employer or school asked for. One flat fee.

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Completed and signed by a state-licensed provider
$49 flat — refunded if the form can't be completed
Usually within 24 hours after we have everything needed
Verifiable by your employer or school

What is a workplace accommodation form?

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 describes the health-related difficulties that affect your work or school activities and the adjustment that addresses them. It includes the information your employer or school needs to decide on your request.

Not your full medical chartThe limits + the accommodation

What if my doctor won't fill out my accommodation form?

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.

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.

Physician StatementAccommodation Letter

What documentation does my employer or school need?

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.

Accommodation letterPhysician StatementLeave as an Accommodation

Can a licensed provider complete my accommodation paperwork online?

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.

HIPAA-compliant

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

How fast can I get it — and what does it cost?

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.

$49 flat— refunded if the form can't be completed
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$49 covers your full accommodation case: clinical review, the supported forms it needs, and any verification, clarification, or corrections — no additional charges.

This page is general information about workplace accommodations, not legal advice. Your employer or school makes the final decision on accommodation requests.

Founded by a nurse practitioner who cares about workers

Rebecca Martel, APRN, FNP-BC

Certicare was founded by Rebecca Martel, APRN, FNP-BC, a family nurse practitioner board certified in family health and licensed in New York State. She started Certicare out of a commitment to workers' rights and a belief that getting the medical documentation you need shouldn't be complicated.

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Licensed in New York State Board Certified in Family Health

You don't need to know exactly which form to request. Complete your intake and a state-licensed provider completes the one your employer or school asked for. School requests use this same intake; where it asks for your employer, enter your school.

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Certicare completes verifiable documentation to standard requirements, but your employer or school makes the final decision on whether to accept it. This is general information, not legal advice.