Note: If not adding company letterhead, consider adding company name and address to this letter.
[Date]
[Employee name]
[Employee address]
Dear [Name]:
This letter is in response to your request for an accommodation to perform the essential functions of your position. The health care provider's note you provided to us on [date] stated that you have the following work restriction(s): [list restrictions]. We met with you on [date] to discuss possible accommodations needed because of these restrictions.
We have approved the following accommodation(s): [list accommodations].
These accommodations are considered the most effective, given your essential job functions and our operational necessities. They will be implemented and effective on [date].
Your records will be maintained in accordance with applicable confidentiality requirements. Please contact me at [phone number or email address] if you have any questions.
Sincerely,
[Supervisor's name]
[Supervisor's job title]
[Supervisor's department]
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