ADA Request Form

The purpose of this form is to collect information regarding disability-related or pregnancy-related needs within your workplace, general disability-related access at the university, or a general barrier to access at the university. This form will be delivered to ADA Compliance and will only be viewed by persons in ADA Compliance.
Personal Information









Hidden Fields

Request

Report An Existing Barrier to Access


Other

If unsure, please select today.







Request a Workplace Accommodation



Pregnancy Accommodation




Accessibility Assistance for Facility or Upcoming Event




Documentation
The Americans with Disabilities Act requires that ADA Compliance keep medical information confidential. However, the law allows ADA Compliance to share information regarding your request accommodation with individuals who are considered to have a legitimate need to know this information. These persons can include your supervisor(s), human resources personnel, first aid and safety personnel, personnel investigating compliance with the ADA, and other persons considered to have a legitimate need to know. The law does not prohibit you from voluntarily discussing your condition or medical information with others.

Submission Notice
This form will be delivered to ADA Compliance and will only be viewed by persons in ADA Compliance. By submitting this form, I recognize that I may need to authorize my medical provider(s) to release information to, and if necessary, speak with ADA Compliance about my medical condition for the purpose of determining appropriate job accommodation(s) for my condition, if the disability is not obvious. Individuals who have questions prior to submitting the form may contact ADA Compliance at adacoordinator@colorado.edu or (303) 492-9725.
Submission Notice
This form will be delivered to ADA Compliance and will only be viewed by persons in ADA Compliance. Individuals who have questions prior to submitting the form may contact ADA Compliance at adacoordinator@colorado.edu or (303) 492-9725.

Contact Information