Request for special equipment form

HRDallas · April 2004

Can anyone provide me with a copy of a form used by employees to request special equipment (such as "I need an ergonomic chair because I have back problems".) The requests for special equipment seems to be increasing and we do not have a formal policy. People often bring in a note from a Dr written on an RX form & it doesn't seem very official, doesn't give reasons etc, and often has a stamped signature, etc. We want the employee to have to provide a specific form completed by a Dr giving the reason, etc for the request. Can anyone help me with this? Thanks so much. You can e-mail forms to [email]afox@moroch.com[/email]

Thanking you in advance!

Don D · May 2004

I don't think you'll find such a universal form. Requests for accommodation result from a required 'interractive process' between the employer and a potentially (or in fact) ADA protected employee. Typically, requests for accommodation take the form of a verbal request from the employee, often accompanied by some written statement from their doctor. I would rather see you turn the request over to some physical therapy specialist with ergonomics knowledge or an occupational clinic and let them help decide on a particular piece of equipment if the doctor cannot be specific enough. "Get him a chair to help his back," or "Pt requires support equipment due to stress secondary to poor posture", is not going to suffice from the doctor. They tell you nothing. Enlist the support of a specialist you have a business relationship with. Such a form as you request doesn't exist.

HRDallas · May 2004

Thanks, Don - I'll do some more checking around & see what I can come up with. I guess I was hoping for a quick solution but should know that such things really do not exist!! Have a good week.

Request for special equipment form

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