[Date]
[Employee name]
[Employee address]
Dear [Name]:
This letter is in response to your request for an Americans with Disabilities Act (ADA) accommodation to perform the essential functions of your position. The health care provider's note that you provided to us on [date] stated that you have the following restrictions: [list restrictions].
We met with you on [date] to discuss possible accommodations you need because of these limitations.
The essential functions of a [employee's job title] require the employee to [list relevant essential job functions]. After a careful review of your request, we have determined we are unable to provide you with a reasonable accommodation at this time because of [reason].
Since we are unable to reasonably accommodate you in your current job, we will attempt to accommodate you by [offering you a transfer, a change to a part-time schedule, or insert another alternative to accommodations requested here] within [Company Name] for which you are qualified. Please let me know if you are interested in the above offer. If you would like to discuss alternative accommodations for your current position, please contact me at [phone number or email address].
Your records related to this accommodation request will be maintained in accordance with applicable confidentiality requirements. Please contact me at [phone number or email address] if you have questions.
Sincerely,
[Employer Representative's name]
[Employer Representative's job title]
[ Employer Representative's department]
[Cc: Supervisor’s name]
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