Request for Accommodation

Princeton University provides reasonable accommodations for employees and individuals to whom a job offer has been made who have a disability. In determining which accommodations are reasonable, the University and the employee have a mutual obligation to engage in a good faith interactive process to explore and discuss options for reasonable modifications.

Your request for a reasonable accommodation, and any information submitted in support of or related to the request, will be kept confidential, except when it needs to be shared with University officials who are involved in evaluating and/or implementing the request.

For questions regarding policy 5.1.7 Reasonable Accommodations for Disability, policy 5.1.8 Accommodations and/or Support for Individuals with Disabilities or Otherwise at a High Risk for Serious Illness Relating to COVID-19, or the interactive process, contact HR at (609) 258-3300 or [email protected]. For questions related to your medical information, email Occupational Health Services (OHS) at [email protected].

Both the employee and healthcare provider forms must be received and reviewed by Occupational Health Services in order to begin the interactive process:
  1. Complete and submit this "Request for Accommodation" webform that goes directly to OHS.
  2. Give your healthcare provider either a printed copy of the "Request for Medical Information from Healthcare Provider" form or a link to it. You must sign the form before your provider sends it to OHS.
  3. Give your healthcare provider a copy of your current job description. You should ask your supervisor for a copy if you do not have it.

Do not include any medical information on this form. Medical information should be provided only on the healthcare provider’s form.

By submitting this completed form to Occupational Health Services (OHS), I understand that I am beginning the interactive accommodation process. I also understand that:
  1. I am responsible for giving the Request for Medical Information from Healthcare Provider form to my healthcare provider to complete.
  2. I must sign the Request for Medical Information from Healthcare Provider form before it is sent to OHS.
  3. I am responsible to make sure that either I or my healthcare provider sends the completed and signed Request for Medical Information from Healthcare Provider form to OHS.