Online Employee Accommodation Request

The following questions with asterisk are required questions. If you’re not sure on how to answer them please state that you’re not sure or put N/A

Type of accommodation requested

Note: If you are seeking a parking accommodation (for any reason including disability or pregnancy) please select "Parking".

If you are seeking an accommodation for job-related travel on university business (for any reason including disability or pregnancy), please select “Travel”.

Note

Accommodations are not retroactive. If you have already traveled and would like to be reimbursed for an additional expense you paid as the result of a disability or pregnancy, please speak with your department. We cannot guarantee that a reimbursement will be granted; departments are not obligated to provide reimbursements when there is no reasonable accommodation in place. The Accessibility and Accommodations Division is not able to authorize retroactive reimbursements.

AAD is currently experiencing a high case load; if possible, please complete this form at least two months before your expected travel date.

UIN

(9-digit ID) - Employees MUST provide their UIN in order for the Division to verify employment status. If you do not know your UIN, please contact your HR representative. If you are a member of the public and do not have a UIN, please enter "N/A."

What is your current work location (building)?

Please specify what religious accommodation you are requesting

For example, time to pray, leave work to attend a religious observance, wear religious attire to work, etc.

Religious Belief, Practice, or Observance

This information will be kept confidential and will only be viewed by OAE staff

If answering No, please explain:

Please state the date[s] or frequency of the requested accommodation

For example, daily, weekly, a specific date

Previous religious accommodation requests

If you have requested religious accommodation before, please state approximately when the request was made, and the outcome of the request.

Describe the accommodation(s) you are requesting.

If you are not sure about the specific accommodation(s) needed, do you have suggestions about what options we can explore?

Please explain

How will this accommodation help?

If you are requesting a specific accommodation, how will the proposed accommodation assist you in performing the essential functions of your job?

Is travel a regular function of your job?

If so, please share how often you travel, on average, per academic year.

What limitations are interfering with your ability to travel without an accommodation?

Examples: bending, concentrating, interacting with others, learning, lifting, sitting, standing, walking, etc.

If the disability/condition is temporary, please state the expected duration.

What limitations are interfering with your ability to perform your job or access an employment benefit?

Examples: bending, concentrating, interacting with others, learning, lifting, sitting, standing, walking, etc

What, if any, job function are you having difficulty performing due to your disability/condition?

What, if any, employment benefit are you having difficulty accessing?

On what date do you expect to travel?

Please note: accommodation requests may take up to 30 days to be facilitated, or longer in periods of high volume.

Please describe past accommodations

On what date do you need your accommodation to start? If unsure, please provide an approximate date

Please note: accommodation requests may take up to 30 days to be facilitated, or longer in periods of high volume

Please indicate your parking space needs

Examples: a designated lot (please indicate which lot), an assigned space, an accessible space with an adjacent loading zone/aisle, etc.

Which lot?

Please provide any additional information that might be useful in processing your accommodation request

Instructions for submitting additional accommodation requests:

Right-click this link to open it in a new tab. AFTER you complete and submit this form, please log in on that page using your NetID and password (the same login information you use to access your university email and other UIUC services). On the right side of the screen, you will see a “Shortcuts” menu. Click “Additional Accommodation Requests” in that menu and then click “Add New.” If you need assistance, please call 217-333-0885 or email accessibility@illinois.edu.

Supervisor's Name

OAE will not discuss your request with your supervisor without your permission.

Supervisor's Phone Number

Supervisor's Email

Unit Human Resources Representative Name

OAE will not discuss your request with your unit HR representative without your permission.

Apartment Leaseholder Full Name

Apartment Leaseholder UIN

Apartment Leaseholder Phone Number

Apartment Leaseholder Email

University Housing Apartment Address

Medical documentation should be uploaded, if available, at the time of your request to move forward in most cases

Medical documentation should not be older than 12 months

Name of Event

Date and Time of Event

Event Host

Who/what department is hosting this event? Please provide contact information, if available

Upload supporting document(s)

Please skip this step if you do not have documentation available now, or if supporting documentation is not needed for your request.

Please use the Accommodation Medical Request Form or Parking Accommodation Medical Form when appropriate.

Requests submitted on the weekend or a holiday will be addressed when the office reopens.

Upon successful submission of your request, you will receive an automated email within 30 minutes. If you do not receive this message, please email accessibility@illinois.edu with your name, UIN, and email address.

Online Employee Accommodation Request

Case Information

Document Information