Reasonable Accommodation Letter: Service Dog

Date: ________________________

Employee's Name: __________________________________________

Phone: ________________________      

Email:_________________________

Job title: _______________________      

 Department:____________________

Supervisor's name: __________________________________________

I am requesting the following reasonable accommodation(s): 

Please see the following attached documents: 

• list of documents supporting your request that have been attached

Answer to the two ADA questions:

1. Is the dog a service dog required for a disability?

       2. What work or task has the dog been trained to perform? 

Employee signature: _________________________________________

Date: ___________

Links for you to print and add:

https://www.eeoc.gov/newsroom/eeoc-sues-hobby-lobby-disability-discimination

https://www.ada.gov/regs2010/service_animal_qa.html

https://beta.ada.gov/topics/service-animals/

https://www.ada.gov/service_animals_2010.htm