* For Staff Accommodation Requests please complete the HR Staff Accommodation Form. Staff Accommodations are addressed by the Yale Human Resources Staff Accommodations Program.
The Office of Institutional Equity and Accessibility (OIEA) administers Yale University’s Accommodation Program for faculty, psychiatry residents, postdoctoral and postgraduate associates and fellowss, and interns with disabilities. Yale provides reasonable accommodations to those with documented disabilities and applicants for employment at Yale who seek accommodations in the job application process due to a disability.
This form will not be placed in your employment record file. The content of this request is confidential.
If this request is related to a work-related injury or illness, you should contact Yale’s Workers’ Compensation office to request an accommodation.
Please have your Health Care Provider or Specialist complete the Health Care Provider/Specialist form; delayed submission of this form will prevent the prompt processing of your request. If you already have a Doctor's or Specialist's note, please upload it below.
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. "Genetic information," as defined by GINA, includes an individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or any individual's family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.